TY - JOUR
T1 - Comparison of outcome of patients with unstable angina and non-Q-wave acute myocardial infarction with and without prior coronary artery bypass grafting (Thrombolysis in Myocardial Ischemia III Registry)
AU - Kleiman, N. S.
AU - Anderson, H. V.
AU - Rogers, W. J.
AU - Theroux, P.
AU - Thompson, B.
AU - Stone, P. H.
N1 - Funding Information:
From Baylor College of Medicine, The Methodist Hospital, and the University of Texas, Houston, Texas; University Medical Center, Birmingham, Alabama; Montrea Montreal, Canada; Maryland Medical Research Maryland; and Bri ham & Womens’ Hospital, setts. The Thromboysrs P. m Myocardial Infarction Centers were supported by Grant ROl -Ht-423 al Heart, Lung, and Blood Institute, Bethesda, Grant ROl-Ht-4242.8 from the Data Coordinating land Medical Research Institute, Baltimore, Maryland. received -I lulv 28, 1995: revised manuscriot received October 9, 1995. Address for reprints: Data Coordinating ical Research Institute, 600 Wyndhurst 21210.
Copyright:
Copyright 2017 Elsevier B.V., All rights reserved.
PY - 1996
Y1 - 1996
N2 - The aim of this study was to characterize patients with and without prior coronary artery bypass grafting (CABG) among a prospectively identified cohort of patients presenting with unstable angina or non-Q-wave myocardial infarction. Patients in the Thrombolysis in Myocardial Infarction phase III Registry Prospective Study presented within 96 hours of an episode of unstable angina or non-Q-wave acute myocardial infarction. Of 2,048 patients, 336 (16.4%) had prior CABG. Compared with those without prior CABG, patients were the same age, but were more likely to be men, white, diabetic, have o history of angina or myocardial infarction, to have received anti-ischemic medications in the prior week, and to receive intravenous heparin or nitroglycerin, or both, during hospitalization. They were equally likely to undergo coronary angioplasty or CABG. Death or nonfatal myocardial infarction occurred by day 10 in 4.5% of patients with prior CABG and 2.8% of patients without prior CABG (p = 0.11); and by day 42 in 7.7% and 5.1%, respectively (p = 0.03). The composite of death, myocardial infarction, or recurrent ischemia at 1 year was more common among patients with prior CABG (39.3% vs 30.2%, p = 0.002). By multiple logistic regression, prior CABG was not independently associated with the occurrence of death or myocardial infarction, or the composite of death, myocardial infarction, or recurrent ischemia either at 6 weeks or at 1 year. The likelihood of recurrent ischemic events is greater among patients with than without prior CABG, but is most likely explained by differences in baseline or treatment characteristics which reflect the degree of underlying cardiac disease.
AB - The aim of this study was to characterize patients with and without prior coronary artery bypass grafting (CABG) among a prospectively identified cohort of patients presenting with unstable angina or non-Q-wave myocardial infarction. Patients in the Thrombolysis in Myocardial Infarction phase III Registry Prospective Study presented within 96 hours of an episode of unstable angina or non-Q-wave acute myocardial infarction. Of 2,048 patients, 336 (16.4%) had prior CABG. Compared with those without prior CABG, patients were the same age, but were more likely to be men, white, diabetic, have o history of angina or myocardial infarction, to have received anti-ischemic medications in the prior week, and to receive intravenous heparin or nitroglycerin, or both, during hospitalization. They were equally likely to undergo coronary angioplasty or CABG. Death or nonfatal myocardial infarction occurred by day 10 in 4.5% of patients with prior CABG and 2.8% of patients without prior CABG (p = 0.11); and by day 42 in 7.7% and 5.1%, respectively (p = 0.03). The composite of death, myocardial infarction, or recurrent ischemia at 1 year was more common among patients with prior CABG (39.3% vs 30.2%, p = 0.002). By multiple logistic regression, prior CABG was not independently associated with the occurrence of death or myocardial infarction, or the composite of death, myocardial infarction, or recurrent ischemia either at 6 weeks or at 1 year. The likelihood of recurrent ischemic events is greater among patients with than without prior CABG, but is most likely explained by differences in baseline or treatment characteristics which reflect the degree of underlying cardiac disease.
UR - http://www.scopus.com/inward/record.url?scp=0030044870&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=0030044870&partnerID=8YFLogxK
U2 - 10.1016/S0002-9149(97)89383-6
DO - 10.1016/S0002-9149(97)89383-6
M3 - Article
C2 - 8607398
AN - SCOPUS:0030044870
VL - 77
SP - 227
EP - 231
JO - American Journal of Cardiology
JF - American Journal of Cardiology
SN - 0002-9149
IS - 4
ER -