Determinants of successful surgical revascularization for failed angioplasty in patients with acute myocardial infarction and cardiogenic shock

Ron Bin Hsu, Robert J. Chen, Shoei Shen Wang, Shu Hsun Chu

研究成果: 雜誌貢獻文章

2 引文 (Scopus)

摘要

Background and Purpose: Previous studies have reported encouraging results with percutaneous transluminal coronary angioplasty (PTCA) in patients with acute myocardial infarction (AMI) and cardiogenic shock (CS). However, PTCA fails in many patients and the mortality rate associated with the procedure is very high. This study sought to assess the determinants of successful coronary artery bypass grafting (CABG) in patients with AMI, CS and failed PTCA. Materials and Methods: From April 1997 to May 2001, 33 patients with a mean age of 62.9 ± 10.5 years underwent CABG for AMI, CS and failed PTCA. PTCA failed or was not attempted because of primary failure in 13 patients, reocclusion in three, no-reflow in one, and multivessel disease in 18. Patients were initially stabilized with inotropic infusion and mechanical circulatory support. Before June 2000, patients underwent conventional CABG, while after June 2000, patients underwent beating heart CABG. Risk factor analysis was performed using retrospective chart review. Results: The overall in-hospital mortality rate was 30.3% - 33.3% in 24 patients who underwent conventional CABG and 22.2% in nine patients who underwent beating heart CABG. Risk factors for death were unstable hemodynamics (p < 0.001), non-right coronary artery as the infarct-related artery (IRA) (p = 0.012), high inotropic dose (p = 0.013), intubation (p = 0.021), cardiopulmonary resuscitation (p = 0.021), and early bypass (p = 0.050). Conclusions: CABG was associated with a high in-hospital mortality rate in patients with AMI, CS and failed PTCA. Patients with unstable hemodynamics and high inotropic dose before surgery had the worst survival rate.
原文英語
頁(從 - 到)815-819
頁數5
期刊Journal of the Formosan Medical Association
101
發行號12
出版狀態已發佈 - 十二月 1 2002
對外發佈Yes

指紋

Cardiogenic Shock
Angioplasty
Myocardial Infarction
Coronary Balloon Angioplasty
Coronary Artery Bypass
Off-Pump Coronary Artery Bypass
Hospital Mortality
Mortality
Hemodynamics
Cardiopulmonary Resuscitation
Intubation
Statistical Factor Analysis
Coronary Vessels
Survival Rate
Arteries

ASJC Scopus subject areas

  • Medicine(all)

引用此文

Determinants of successful surgical revascularization for failed angioplasty in patients with acute myocardial infarction and cardiogenic shock. / Hsu, Ron Bin; Chen, Robert J.; Wang, Shoei Shen; Chu, Shu Hsun.

於: Journal of the Formosan Medical Association, 卷 101, 編號 12, 01.12.2002, p. 815-819.

研究成果: 雜誌貢獻文章

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title = "Determinants of successful surgical revascularization for failed angioplasty in patients with acute myocardial infarction and cardiogenic shock",
abstract = "Background and Purpose: Previous studies have reported encouraging results with percutaneous transluminal coronary angioplasty (PTCA) in patients with acute myocardial infarction (AMI) and cardiogenic shock (CS). However, PTCA fails in many patients and the mortality rate associated with the procedure is very high. This study sought to assess the determinants of successful coronary artery bypass grafting (CABG) in patients with AMI, CS and failed PTCA. Materials and Methods: From April 1997 to May 2001, 33 patients with a mean age of 62.9 ± 10.5 years underwent CABG for AMI, CS and failed PTCA. PTCA failed or was not attempted because of primary failure in 13 patients, reocclusion in three, no-reflow in one, and multivessel disease in 18. Patients were initially stabilized with inotropic infusion and mechanical circulatory support. Before June 2000, patients underwent conventional CABG, while after June 2000, patients underwent beating heart CABG. Risk factor analysis was performed using retrospective chart review. Results: The overall in-hospital mortality rate was 30.3{\%} - 33.3{\%} in 24 patients who underwent conventional CABG and 22.2{\%} in nine patients who underwent beating heart CABG. Risk factors for death were unstable hemodynamics (p < 0.001), non-right coronary artery as the infarct-related artery (IRA) (p = 0.012), high inotropic dose (p = 0.013), intubation (p = 0.021), cardiopulmonary resuscitation (p = 0.021), and early bypass (p = 0.050). Conclusions: CABG was associated with a high in-hospital mortality rate in patients with AMI, CS and failed PTCA. Patients with unstable hemodynamics and high inotropic dose before surgery had the worst survival rate.",
keywords = "Acute myocardial infarction, Cardiogenic schock, Coronary angioplasty, Coronary artery bypass, Percutaneous transluminal",
author = "Hsu, {Ron Bin} and Chen, {Robert J.} and Wang, {Shoei Shen} and Chu, {Shu Hsun}",
year = "2002",
month = "12",
day = "1",
language = "English",
volume = "101",
pages = "815--819",
journal = "Journal of the Formosan Medical Association",
issn = "0929-6646",
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T1 - Determinants of successful surgical revascularization for failed angioplasty in patients with acute myocardial infarction and cardiogenic shock

AU - Hsu, Ron Bin

AU - Chen, Robert J.

AU - Wang, Shoei Shen

AU - Chu, Shu Hsun

PY - 2002/12/1

Y1 - 2002/12/1

N2 - Background and Purpose: Previous studies have reported encouraging results with percutaneous transluminal coronary angioplasty (PTCA) in patients with acute myocardial infarction (AMI) and cardiogenic shock (CS). However, PTCA fails in many patients and the mortality rate associated with the procedure is very high. This study sought to assess the determinants of successful coronary artery bypass grafting (CABG) in patients with AMI, CS and failed PTCA. Materials and Methods: From April 1997 to May 2001, 33 patients with a mean age of 62.9 ± 10.5 years underwent CABG for AMI, CS and failed PTCA. PTCA failed or was not attempted because of primary failure in 13 patients, reocclusion in three, no-reflow in one, and multivessel disease in 18. Patients were initially stabilized with inotropic infusion and mechanical circulatory support. Before June 2000, patients underwent conventional CABG, while after June 2000, patients underwent beating heart CABG. Risk factor analysis was performed using retrospective chart review. Results: The overall in-hospital mortality rate was 30.3% - 33.3% in 24 patients who underwent conventional CABG and 22.2% in nine patients who underwent beating heart CABG. Risk factors for death were unstable hemodynamics (p < 0.001), non-right coronary artery as the infarct-related artery (IRA) (p = 0.012), high inotropic dose (p = 0.013), intubation (p = 0.021), cardiopulmonary resuscitation (p = 0.021), and early bypass (p = 0.050). Conclusions: CABG was associated with a high in-hospital mortality rate in patients with AMI, CS and failed PTCA. Patients with unstable hemodynamics and high inotropic dose before surgery had the worst survival rate.

AB - Background and Purpose: Previous studies have reported encouraging results with percutaneous transluminal coronary angioplasty (PTCA) in patients with acute myocardial infarction (AMI) and cardiogenic shock (CS). However, PTCA fails in many patients and the mortality rate associated with the procedure is very high. This study sought to assess the determinants of successful coronary artery bypass grafting (CABG) in patients with AMI, CS and failed PTCA. Materials and Methods: From April 1997 to May 2001, 33 patients with a mean age of 62.9 ± 10.5 years underwent CABG for AMI, CS and failed PTCA. PTCA failed or was not attempted because of primary failure in 13 patients, reocclusion in three, no-reflow in one, and multivessel disease in 18. Patients were initially stabilized with inotropic infusion and mechanical circulatory support. Before June 2000, patients underwent conventional CABG, while after June 2000, patients underwent beating heart CABG. Risk factor analysis was performed using retrospective chart review. Results: The overall in-hospital mortality rate was 30.3% - 33.3% in 24 patients who underwent conventional CABG and 22.2% in nine patients who underwent beating heart CABG. Risk factors for death were unstable hemodynamics (p < 0.001), non-right coronary artery as the infarct-related artery (IRA) (p = 0.012), high inotropic dose (p = 0.013), intubation (p = 0.021), cardiopulmonary resuscitation (p = 0.021), and early bypass (p = 0.050). Conclusions: CABG was associated with a high in-hospital mortality rate in patients with AMI, CS and failed PTCA. Patients with unstable hemodynamics and high inotropic dose before surgery had the worst survival rate.

KW - Acute myocardial infarction

KW - Cardiogenic schock

KW - Coronary angioplasty

KW - Coronary artery bypass

KW - Percutaneous transluminal

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