Acute myocardial infarction-cardiogenic shock in patients with prior coronary artery bypass grafting: A 16-year national cohort analysis of temporal trends, management and outcomes

Published on Jul 1, 2020in International Journal of Cardiology4.164
· DOI :10.1016/J.IJCARD.2020.02.033
Saraschandra Vallabhajosyula10
Estimated H-index: 10
(Mayo Clinic),
Vinayak Kumar5
Estimated H-index: 5
(Mayo Clinic)
+ 9 AuthorsGregory W. Barsness41
Estimated H-index: 41
(Mayo Clinic)
Sources
Abstract
Abstract Background There are limited data on the outcomes of acute myocardial infarction with cardiogenic shock (AMI-CS) in patients with prior coronary artery bypass grafting (CABG). Methods A retrospective cohort of AMI-CS admissions during 2000–2016 from the National Inpatient Sample was created and prior CABG status was identified. Outcomes of interest included in-hospital mortality and resource utilization in the two cohorts. Temporal trends of prevalence, in-hospital mortality, and cardiac procedures were evaluated. Results In 513,288 AMI-CS admissions, prior CABG was performed in 22,832 (4.4%). Adjusted temporal trends showed a 2-fold increase in CS in both cohorts. There was a temporal increase in coronary angiography and percutaneous coronary intervention (PCI) across both cohorts. The cohort with prior CABG was on average older, of male sex, of white race, and with higher comorbidity. The cohort with prior CABG received coronary angiography (50% vs. 75%), PCI (32% vs. 49%), right heart catheterization/pulmonary artery catheterization (15% vs. 20%), mechanical circulatory support (26% vs. 46%) less frequently compared to those without (all p  Conclusions In AMI-CS, admission with prior CABG was older and had lower use of cardiac procedures and higher in-hospital mortality compared to those without prior CABG.
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