Short- and long-term outcomes of ST-segment elevation myocardial infarction treated with CABG: a population-based cohort study.

OBJECTIVES

To investigate the outcomes of patients with ST-elevation myocardial infarction (STEMI) who were treated with coronary artery bypass grafting (CABG) surgery.

DESIGN

Retrospective nationwide cohort study.

SETTING

Patients with STEMI in Finland who were treated with CABG between January 2004 and December 2018.

PARTICIPANTS

1069 patients (mean age: 66.4, 21.4% women).

PRIMARY OUTCOME MEASURE

All-cause mortality (median follow-up 6.4 years) and usage of evidence-based secondary preventive medication early after CABG.

RESULTS

In-hospital mortality among the total cohort was 10.0%, with a significant decrease (p<0.0001) during the study period. Cumulative 10-year mortality was 38.3%. Age, diabetes, renal disease, early surgery, usage of only venous grafts and concomitant procedures were associated with in-hospital mortality in multivariable modelling. Age, cerebrovascular disease, diabetes, heart failure, peripheral vascular disease, rheumatic disease and venous-only grafts were associated with 10-year mortality. Statins and beta blockers were used by >90% of patients and ACE inhibitors/angiotensin II receptor blockers by 70% of patients after discharge from the hospital. The proportion of high-dose statin users increased from 33.1% in 2004-2008 to 63.1% in 2014-2018. ADP inhibitors were used by 29.0% of patients, but the proportion increased during the study.

CONCLUSIONS

Contemporary in-hospital and long-term outcomes of CABG-treated patients with STEMI are acceptable. In-hospital mortality has decreased, and the usage of secondary prevention medications after CABG procedures has increased in recent years.