Division of Cardiology, Henry Ford Hospital, Detroit, Michigan.
Department of Medicine, Albert Einstein Medical Center, Philadelphia, Pennsylvania.
Am J Cardiol. 2022 Sep 15;179:11-17. doi: 10.1016/j.amjcard.2022.06.002. Epub 2022 Jul 20.
Data on myocardial infarction (MI) treatment in patients with previous coronary artery bypass grafting (CABG) is limited. We queried the Nationwide Readmissions Database to identify hospitalizations of patients with MI from 2016 to 2019. Among hospitalized patients presenting with MI, 10.3% had previous CABG. Patients with MI who had previous CABG were less likely to be revascularized than those without previous CABG for both ST-segment elevation MI (STEMI) (46.4% vs 68.4%) and non-ST-segment elevation MI (NSTEMI) (30.8% vs 36.7%). CABG was associated with a lower risk of death in NSTEMI patients (odds ratio [OR] 0.84, 95% confidence interval [CI] 0.82 to 0.86), but a higher risk in STEMI patients (OR 1.06, 95% CI 1.01 to 1.13). Revascularization was associated with a lower risk of in-hospital death in patients with previous CABG presenting with STEMI (OR 0.30, 95% CI 0.26 to 0.35) and NSTEMI (OR 0.21, 95% CI 0.19 to 0.23).
关于有既往冠状动脉旁路移植术（CABG）史的患者心肌梗死（MI）治疗的数据有限。我们查询了全国再入院数据库，以确定 2016 年至 2019 年期间 MI 住院患者的情况。在 MI 住院患者中，有 10.3%的患者有既往 CABG 史。与无既往 CABG 史的 MI 患者相比，既往 CABG 史的 MI 患者进行血运重建的可能性较小，无论是 ST 段抬高型心肌梗死（STEMI）（46.4% vs 68.4%）还是非 ST 段抬高型心肌梗死（NSTEMI）（30.8% vs 36.7%）。对于 NSTEMI 患者，CABG 与较低的死亡风险相关（比值比 [OR] 0.84，95%置信区间 [CI] 0.82 至 0.86），但在 STEMI 患者中则与较高的死亡风险相关（OR 1.06，95% CI 1.01 至 1.13）。对于有既往 CABG 史的 STEMI（OR 0.30，95% CI 0.26 至 0.35）和 NSTEMI（OR 0.21，95% CI 0.19 至 0.23）患者，血运重建与住院期间死亡风险降低相关。
