Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2022 Dec 16;12(12):2124.
doi: 10.3390/life12122124.

Outcomes of Emergent Isolated Coronary Bypass Grafting in Heart Failure Patients

Giacomo Bianchi  1 , Edoardo Zancanaro  2 , Rafik Margaryan  1 , Giovanni Concistré  1 , Egidio Varone  1 , Simone Simeoni  1 , Marco Solinas  1
Affiliations

Outcomes of Emergent Isolated Coronary Bypass Grafting in Heart Failure Patients

Giacomo Bianchi et al. Life (Basel). .

Abstract

Patients with previously diagnosed HF are at greater risk for subsequent morbidity and mortality when hospitalized for an Acute Myocardial Infarction (AMI). The purpose of our study was to describe the time trend of the incidence of emergent CABG in patients with and without HF, the clinical characteristics, outcomes, and the risk factors for mortality of surgical revascularization in the short and medium term. This was a single-center retrospective observational study of patients who underwent isolated emergency CABG from January 2009 to January 2020. A propensity-score matching analysis yielded two comparable groups (n = 430) of patients without (n = 215) and with (n = 215) heart failure. In-hospital mortality did not differ in the two groups (2.8%; p > 0.9); the patients with heart failure presented more frequently with cardiogenic shock, and there was an association with mortality and mechanical circulatory support (OR 16.7−95% CI 3.31−140; p = 0.002) and postoperative acute renal failure (OR 15.9−95% CI 0.66−203; p = 0.036). In the early- and mid-term, heart failure and NSTEMI were associated with mortality (HR 3.47−95% CI 1.15−10.5; p = 0.028), along with age (HR 1.28−95% CI 1.21−1.36; p < 0.001). Surgical revascularization offers an excellent solution for patients with acute coronary syndrome, leading to a good immediate prognosis even in those with chronic heart failure.

Keywords: emergent CABG; heart failure; outcomes.

PubMed Disclaimer

Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Temporal trend of patients with ACS treated by surgical revascularization (CABG). The left side of the figure outlines the increasing trend of patients with ACS without CHF with a prevalence of NSTEMIs; this trend is also present in the group of patients with CHF, where NSTEMIs have been more frequent over the years. Also noted is the decrease of cases in the year 2020, due to the SARS-CoV2 pandemic.
Figure 2
Figure 2
Survival of patients operated on with emergent CABG according to the preoperative diagnosis of chronic heart failure. The patients with heart failure had significantly lower survival compared to the control group; furthermore, the worst prognosis was for patients with chronic heart failure and the NSTEMI type of acute coronary syndrome.
See this image and copyright information in PMC

References

    1. Heidenreich P.A., Bozkurt B., Aguilar D., Allen L.A., Byun J.J., Colvin M.M., Deswal A., Drazner M.H., Dunlay S.M., Evers L.R., et al. 2022 AHA/ACC/HFSA Guideline for the Management of Heart Failure: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines. Circulation. 2022;145:e895–e1032. doi: 10.1161/CIR.0000000000001063. - DOI - PubMed
    1. Wu A.H., Parsons L., Every N.R., Bates E.R., Second National Registry of Myocardial Infarction Hospital Outcomes in Patients Presenting with Congestive Heart Failure Complicating Acute Myocardial Infarction: A Report from the Second National Registry of Myocardial Infarction (NRMI-2) J. Am. Coll. Cardiol. 2002;40:1389–1394. doi: 10.1016/S0735-1097(02)02173-3. - DOI - PubMed
    1. Roe M.T., Chen A.Y., Riba A.L., Goswami R.G., Peacock W.F., Pollack C.V., Collins S.P., Gibler W.B., Ohman E.M., Peterson E.D., et al. Impact of Congestive Heart Failure in Patients with Non-ST-segment Elevation Acute Coronary Syndromes. Am. J. Cardiol. 2006;97:1707–1712. doi: 10.1016/j.amjcard.2005.12.068. - DOI - PubMed
    1. Steg P.G., Kerner A., Van de Werf F., López-Sendón J., Gore J.M., Fitzgerald G., Feldman L.J., Anderson F.A., Avezum A., Global Registry of Acute Coronary Events (GRACE) Investigators Impact of In-Hospital Revascularization on Survival in Patients with Non-ST-elevation Acute Coronary Syndrome and Congestive Heart Failure. Circulation. 2008;118:1163–1171. doi: 10.1161/CIRCULATIONAHA.108.789685. - DOI - PubMed
    1. Schumer E.M., Chaney J.H., Trivedi J.R., Linsky P.L., Williams M.L., Slaughter M.S. Emergency Coronary Artery Bypass Grafting: Indications and Outcomes from 2003 through 2013. Tex. Heart Inst. J. 2016;43:214–219. doi: 10.14503/THIJ-14-4978. - DOI - PMC - PubMed