Role of surgical revascularization in treatment of acute coronary syndrome without ST elevation

    Authors

    Keywords

    coronary artery bypass graft surgery, acute coronary syndrome without ST elevation, coronary artery disease, acute coronary syndrome

    DOI

    https://doi.org/10.15836/ccar2016.453

    Full Text

    In accordance with the current guidelines for the treatment of acute coronary syndrome without ST elevation (NSTEMI ACS) surgical revascularization is indicated in approximately 12% of patients who were admitted to hospital with the diagnosis. (1) The aim of study was to re-evaluate the role of surgical revascularization in patients hospitalized in University Clinic for Cardiovascular Diseases Magdalena with a diagnosis of ACS NSTEMI for a period of three years from 1st January 2012 to 1st January 2015 (we included patients who were admitted to our clinic within 24 hours of onset of symptoms for further treatment). During this time period there were a total of 174 hospitalized patients with the diagnosis of ACS-NSTEMI. Of these 174 patients in all was coronary angiography performed. In view of the findings of coronary angiography in 127 patients (73%) underwent PCI, in 27 patients (15%) further conservative therapy was indicated, and in 20 patients (11%) underwent coronary artery bypass graft surgery (CABG). Hospital mortality in patients who underwent CABG was 1.7% (3 patients). In the treatment strategy for ACS-NSTEMI there is key role of heart-team - which sets indication for adequate revascularization strategy (PCI vs. conservative therapy vs. CABG). The obtained results have shown significant and irreplaceable role of cardiac surgery in revascularization in patients with ACS NSTEMI.

    Literature

    1. Roffi M, Patrono C, Collet JP, Mueller C, Valgimigli M, Andreotti F, et al. Management of Acute Coronary Syndromes in Patients Presenting without Persistent ST-Segment Elevation of the European Society of Cardiology. 2015 ESC Guidelines for the management of acute coronary syndromes in patients presenting without persistent ST-segment elevation: Task Force for the Management of Acute Coronary Syndromes in Patients Presenting without Persistent ST-Segment Elevation of the European Society of Cardiology (ESC). Eur Heart J. 2016;37(3):267–315. https://doi.org/10.1093/eurheartj/ehv320
    Cardiologia Croatica
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    Role of surgical revascularization in treatment of acute coronary syndrome without ST elevation

    Extended Abstract
    Issue10-11
    Published
    Pages453
    PDF via DOIhttps://doi.org/10.15836/ccar2016.453
    coronary artery bypass graft surgery
    acute coronary syndrome without ST elevation
    coronary artery disease
    acute coronary syndrome

    Authors

    Igor Šesto*ORCIDUniversity Clinic for Cardiovascular Diseases Magdalena, Krapinske Toplice, Croatia

    *Correspondence email: igor.sesto@magdalena.hr

    Full Text

    In accordance with the current guidelines for the treatment of acute coronary syndrome without ST elevation (NSTEMI ACS) surgical revascularization is indicated in approximately 12% of patients who were admitted to hospital with the diagnosis. (1)

    The aim of study was to re-evaluate the role of surgical revascularization in patients hospitalized in University Clinic for Cardiovascular Diseases Magdalena with a diagnosis of ACS NSTEMI for a period of three years from 1st January 2012 to 1st January 2015 (we included patients who were admitted to our clinic within 24 hours of onset of symptoms for further treatment). During this time period there were a total of 174 hospitalized patients with the diagnosis of ACS-NSTEMI. Of these 174 patients in all was coronary angiography performed. In view of the findings of coronary angiography in 127 patients (73%) underwent PCI, in 27 patients (15%) further conservative therapy was indicated, and in 20 patients (11%) underwent coronary artery bypass graft surgery (CABG). Hospital mortality in patients who underwent CABG was 1.7% (3 patients). In the treatment strategy for ACS-NSTEMI there is key role of heart-team - which sets indication for adequate revascularization strategy (PCI vs. conservative therapy vs. CABG).

    The obtained results have shown significant and irreplaceable role of cardiac surgery in revascularization in patients with ACS NSTEMI.

    Literature

    1. 1.
      Roffi M, Patrono C, Collet JP, Mueller C, Valgimigli M, Andreotti F, et al. Management of Acute Coronary Syndromes in Patients Presenting without Persistent ST-Segment Elevation of the European Society of Cardiology. 2015 ESC Guidelines for the management of acute coronary syndromes in patients presenting without persistent ST-segment elevation: Task Force for the Management of Acute Coronary Syndromes in Patients Presenting without Persistent ST-Segment Elevation of the European Society of Cardiology (ESC). Eur Heart J. 2016;37(3):267–315.DOI