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The Association of Previous Revascularization With In-Hospital Outcomes in Acute Myocardial Infarction Patients: Results From the National Cardiovascular Data Registry.

Publication ,  Journal Article
Gruberg, L; Hellkamp, AS; Thomas, LE; de Lemos, JA; Scirica, BM; Hilliard, A; Enriquez, JR; Mohsen, A; Wang, TY
Published in: JACC Cardiovasc Interv
December 28, 2015

OBJECTIVES: The aim of this study was to compare outcomes of ST-segment elevation myocardial infarction (STEMI) patients with a history of coronary artery bypass graft surgery (CABG), previous percutaneous coronary intervention (PCI), or no previous revascularization undergoing primary PCI. BACKGROUND: Limited data exist regarding door-to-balloon times and clinical outcomes of STEMI patients with a history of CABG or PCI undergoing primary PCI. METHODS: We examined 15,628 STEMI patients who underwent primary PCI at 297 sites in the United States. We used multivariable logistic regression analyses to compare door-to-balloon time delays >90 min and in-hospital major adverse cardiovascular or cerebrovascular events (MACCE). RESULTS: Patients with previous CABG were significantly older and more likely to have multiple comorbidities (p < 0.0001). Previous CABG was associated with a lower likelihood of a door-to-balloon time ≤90 min compared with patients with no previous revascularization. However, no significant differences in door-to-balloon times were noted between patients with previous PCI and those without previous revascularization. The unadjusted MACCE risk was significantly higher in patients with a history of CABG compared with patients without previous revascularization (odds ratio: 1.68, 95% confidence interval: 1.23 to 2.31). However, after multivariable risk adjustment, there were no significant differences in MACCE risk between the 2 groups. No significant differences in in-hospital outcomes were seen in patients with a previous PCI and those without previous revascularization. CONCLUSIONS: In a large cohort of STEMI patients undergoing primary PCI, patients with previous CABG were more likely to have reperfusion delays, yet risk-adjusted, in-hospital outcomes were similar to those without previous revascularization. No significant differences in reperfusion timeliness and in-hospital outcomes were seen in patients with a history of PCI compared with patients without previous revascularization.

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Published In

JACC Cardiovasc Interv

DOI

EISSN

1876-7605

Publication Date

December 28, 2015

Volume

8

Issue

15

Start / End Page

1954 / 1962

Location

United States

Related Subject Headings

  • United States
  • Treatment Outcome
  • Time-to-Treatment
  • Time Factors
  • Risk Factors
  • Risk Assessment
  • Retreatment
  • Registries
  • Percutaneous Coronary Intervention
  • Odds Ratio
 

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Gruberg, L., Hellkamp, A. S., Thomas, L. E., de Lemos, J. A., Scirica, B. M., Hilliard, A., … Wang, T. Y. (2015). The Association of Previous Revascularization With In-Hospital Outcomes in Acute Myocardial Infarction Patients: Results From the National Cardiovascular Data Registry. JACC Cardiovasc Interv, 8(15), 1954–1962. https://doi.org/10.1016/j.jcin.2015.08.030
Gruberg, Luis, Anne S. Hellkamp, Laine E. Thomas, James A. de Lemos, Benjamin M. Scirica, Anthony Hilliard, Jonathan R. Enriquez, Amr Mohsen, and Tracy Y. Wang. “The Association of Previous Revascularization With In-Hospital Outcomes in Acute Myocardial Infarction Patients: Results From the National Cardiovascular Data Registry.JACC Cardiovasc Interv 8, no. 15 (December 28, 2015): 1954–62. https://doi.org/10.1016/j.jcin.2015.08.030.
Gruberg L, Hellkamp AS, Thomas LE, de Lemos JA, Scirica BM, Hilliard A, et al. The Association of Previous Revascularization With In-Hospital Outcomes in Acute Myocardial Infarction Patients: Results From the National Cardiovascular Data Registry. JACC Cardiovasc Interv. 2015 Dec 28;8(15):1954–62.
Gruberg, Luis, et al. “The Association of Previous Revascularization With In-Hospital Outcomes in Acute Myocardial Infarction Patients: Results From the National Cardiovascular Data Registry.JACC Cardiovasc Interv, vol. 8, no. 15, Dec. 2015, pp. 1954–62. Pubmed, doi:10.1016/j.jcin.2015.08.030.
Gruberg L, Hellkamp AS, Thomas LE, de Lemos JA, Scirica BM, Hilliard A, Enriquez JR, Mohsen A, Wang TY. The Association of Previous Revascularization With In-Hospital Outcomes in Acute Myocardial Infarction Patients: Results From the National Cardiovascular Data Registry. JACC Cardiovasc Interv. 2015 Dec 28;8(15):1954–1962.
Journal cover image

Published In

JACC Cardiovasc Interv

DOI

EISSN

1876-7605

Publication Date

December 28, 2015

Volume

8

Issue

15

Start / End Page

1954 / 1962

Location

United States

Related Subject Headings

  • United States
  • Treatment Outcome
  • Time-to-Treatment
  • Time Factors
  • Risk Factors
  • Risk Assessment
  • Retreatment
  • Registries
  • Percutaneous Coronary Intervention
  • Odds Ratio