Detrimental effect of perioperative myocardial infarction on late survival after coronary artery bypass. Report from the Coronary Artery Surgery Study - CASS

H. V. Schaff, B. J. Gersh, L. D. Fisher, R. L. Frye, M. B. Mock, T. J. Ryan, R. B. Ells, B. R. Chaitman, E. L. Alderman, G. C. Kaiser

Research output: Contribution to journalArticle

57 Scopus citations

Abstract

The influence of perioperative myocardial infarction on late survival after coronary artery bypass grafting was reviewed in 9,777 patients who underwent operation between 1974 and 1979. Definite or probable perioperative myocardial infarction was diagnosed in 561 patients (5.7%). The incidence decreased from 6.6% in 1974 to 4.1% in 1979 (p < 0.005). Actuarial survival, including hospital deaths, at 1, 3, and 5 years was significantly greater in patients without infarction than in patients with infarction (96%, 94%, and 90% versus 78%, 74%, and 69%; p < 0.0001). The difference persisted among patients dismissed from the hospital. Reduction in late survival among patients with perioperative infarction was due to the poor outcome of those who had complications (5 year survival rates 40% overall and 73% for patients dismissed from the hospital). Multivariate analysis identified perioperative mycoardial infarction as an important independent predictor of late survival after bypass grafting; it was surpassed only by left ventricular function (wall motion score), age, and number of associated medical diseases.

Original languageEnglish (US)
Pages (from-to)972-981
Number of pages10
JournalJournal of Thoracic and Cardiovascular Surgery
Volume88
Issue number6
DOIs
StatePublished - 1984

ASJC Scopus subject areas

  • Surgery
  • Pulmonary and Respiratory Medicine
  • Cardiology and Cardiovascular Medicine

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