Impact of Perioperative Myocardial Infarction on Angiographic and Clinical Outcomes Following Coronary Artery Bypass Grafting (from PRoject of Ex-vivo Vein graft ENgineering via Transfection [PREVENT] IV)

• Published in: The American journal of cardiology 2008-09, Vol.102 (5), p.546-551
• Main Authors: Yau, James M., MD, Alexander, John H., MD, MHS, Hafley, Gail, MS, Mahaffey, Kenneth W., MD, Mack, Michael J., MD, Kouchoukos, Nicholas, MD, Goyal, Abhinav, MD, MHS, Peterson, Eric D., MD, MPH, Gibson, C. Michael, MD, Califf, Robert M., MD, Harrington, Robert A., MD, Ferguson, T. Bruce, MD
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Aged; Aged, 80 and over; Biological and medical sciences; Cardiology; Cardiology. Vascular system; Cardiovascular; Cardiovascular system; Clinical medicine; Clinical outcomes; Coronary Angiography - methods; Coronary Artery Bypass - instrumentation; Coronary heart disease; Double-Blind Method; Electrocardiography; Female; Follow-Up Studies; Genetic Engineering - methods; Heart; Heart attacks; Heart surgery; Humans; Investigative techniques, diagnostic techniques (general aspects); Male; Medical imaging; Medical sciences; Middle Aged; Myocardial Infarction - diagnostic imaging; Myocardial Infarction - physiopathology; Myocardial Infarction - surgery; Myocarditis. Cardiomyopathies; Postoperative Complications - epidemiology; Postoperative Complications - prevention & control; Prosthesis Design; Radiodiagnosis. Nmr imagery. Nmr spectrometry; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Surgery of the heart; Time Factors; Transfection - methods; Treatment Outcome; Veins - transplantation
• ISSN: 0002-9149; 1879-1913
• DOI: 10.1016/j.amjcard.2008.04.069

Myocardial infarction (MI) after coronary artery bypass grafting (CABG) is associated with significant morbidity and mortality. Frequency, management, mechanisms, and angiographic and clinical outcomes associated with perioperative MI remain poorly understood. PREVENT IV was a multicenter, randomized, placebo-controlled trial of edifoligide in 3,014 patients undergoing CABG. Angiographic and 2-year clinical follow-up were complete for 1,920 and 2,956 patients, respectively. Perioperative MI was defined as creatinine kinase-MB increase ≥10 times the upper limit of normal or ≥5 times the upper limit of normal with new 30-ms Q waves within 24 hours of surgery. Baseline characteristics, in-hospital management, and angiographic and clinical outcomes of patients with and without perioperative MI were compared. Perioperative MI occurred in 294 patients (9.8%). Patients with perioperative MI had longer surgery (250 vs 230 minutes; p