TY  - BOOK
AU  - Hynes, Conor F
TI  - Coronary Artery Bypass Grafting During Acute Coronary Syndrome: Outcomes and Comparison of Off-Pump to Conventional Coronary Artery Bypass Grafting at a Veteran Affairs Hospital
SN  - 1556-9845
PY  - 2015///
KW  - *Acute Coronary Syndrome/su [Surgery]
KW  - *Coronary Artery Bypass, Off-Pump/mt [Methods]
KW  - *Coronary Artery Bypass/mt [Methods]
KW  - Acute Coronary Syndrome/pp [Physiopathology]
KW  - Aged
KW  - Comorbidity
KW  - Coronary Artery Bypass, Off-Pump/ae [Adverse Effects]
KW  - Coronary Artery Bypass/ae [Adverse Effects]
KW  - Female
KW  - Follow-Up Studies
KW  - Humans
KW  - Kaplan-Meier Estimate
KW  - Length of Stay
KW  - Male
KW  - Middle Aged
KW  - Proportional Hazards Models
KW  - Retrospective Studies
KW  - Risk Factors
KW  - Survival Rate
KW  - Treatment Outcome
KW  - United States
KW  - United States Department of Veterans Affairs
KW  - MedStar Washington Hospital Center
KW  - Surgery/General SurgeryIN  - Emerson,Dominic A. From the *Veterans Affairs Medical Center; +Georgetown University Hospital; and ++The George Washington University Hospital, Washington, DC USA
KW  - Comparative Study
KW  - Journal Article
N1  - Available online through MWHC library: Fall 2005 - present
N2  - CONCLUSIONS: ACS appears to negatively impact long-term, but not short-term, mortality. Within the ACS group, OPCABG compares favorably to cCABG in the long-term and also improves short-term morbidity; METHODS: A retrospective review of prospectively collected data was undertaken. Patients undergoing isolated CABG from January 2000 to December 2011 with ACS were identified (n = 271); non-ACS patients (n = 854) were established as a control. Data were analyzed with a chi or a t test, where appropriate. Survival was compared using Kaplan-Meier analysis and Cox proportional hazards model; OBJECTIVE: The management of acute coronary syndrome (ACS) has evolved dramatically over the last 50 years. Currently, management includes a multidisciplinary approach potentially including catheter-based therapy, surgery, or purely medical management. Where surgical therapy is indicated, data regarding long-term outcomes are limited. In particular, little data exist regarding on-pump (conventional coronary artery bypass grafting, cCABG) versus off-pump (OPCABG) outcomes for this group; RESULTS: Thirty-day mortality between the ACS and the control groups was similar; however, long-term mortality was worse for the ACS group (P = 0.032; median follow-up, 5.5 years). Length of stay and composite morbidity were higher in the ACS group (P < 0.01). Subgroup analysis of ACS patients (OPCABG vs cCABG) demonstrated worse preoperative comorbidities in the OPCABG group, but similar 30-day and long-term mortality. However, the cCABG group had higher rates of reoperation (P = 0.034) and longer length of stay (P = 0.017) and operative time (P < 0.0001). Cox proportional hazards model was applied. Risk factors for the non-ACS cohort included age, diabetes, OPCABG, and ACS (P < 0.05). Among the ACS cohort, only age remained a statistically significant factor (P < 0.0001)
UR  - http://dx.doi.org/10.1097/IMI.0000000000000159
ER  -