Interv Akut Kardiol. 2004;3(2):83-85
ACUTE MYOCARDIAL INFARCTION IN PATIENTS WITH THE HISTORY OF CORONARY ARTERY BYPASS GRAFTING
- Kardiochirurgická klinika LF UK a Kardiocentrum FN Hradec Králové
The patients with the history of coronary artery bypass grafting (CABG) admitted for acute myocardial infarction (AMI) have uncertain prognosis. These patients are mostly polymorbid, have low ejection fraction of the left ventricle and triple vessel disease. AMI has often atypical manifestation in these patients, is smaller and has worse prognosis. The patients with the history of CABG are less often treated by reperfusion therapy compared to the patients without the history of CABG. The prognosis is especially unfavourable, when the venous bypass is an infarct-related artery. The primary percutaneous coronary intervention achieves better results in the treatment of these patients in comparison to thrombolysis; unfortunatelly both methods of treatment have worse results than in patients without the history of CABG.
Keywords: acute myocardial infarction, aortocoronary bypass, primary percutaneous coronary interventions, thrombolysis.
Published: December 31, 2004 Show citation
Pacienti po chirurgické revaskularizaci myokardu (CABG - coronary artery bypass grafting), kteří jsou hospitalizováni pro akutní infarkt myokardu (AIM), jsou velmi rizikoví. Jde vesměs o polymorbidní nemocné s nízkou ejekční frakcí (EF) levé komory a postižením 3 arterií. AIM se u nich často manifestuje atypicky, je rozsahem menší a má horší prognózu. Reperfuzní léčbou jsou tito nemocní léčeni méně často, než nemocní bez anamnézy CABG. Je-li infarktovou tepnou žilní štěp, je prognóza nemocného obzvláště nepříznivá. Primární perkutánní koronární intervence (PCI) dosahuje v léčbě pacientů s anamnézou CABG lepších výsledků, než trombolýza (TL); obě léčebné metody však mají u této skupiny pacientů horší výsledky, než u pacientů doposud neoperovaných.
ACUTE MYOCARDIAL INFARCTION IN PATIENTS WITH THE HISTORY OF CORONARY ARTERY BYPASS GRAFTING
The patients with the history of coronary artery bypass grafting (CABG) admitted for acute myocardial infarction (AMI) have uncertain prognosis. These patients are mostly polymorbid, have low ejection fraction of the left ventricle and triple vessel disease. AMI has often atypical manifestation in these patients, is smaller and has worse prognosis. The patients with the history of CABG are less often treated by reperfusion therapy compared to the patients without the history of CABG. The prognosis is especially unfavourable, when the venous bypass is an infarct-related artery. The primary percutaneous coronary intervention achieves better results in the treatment of these patients in comparison to thrombolysis; unfortunatelly both methods of treatment have worse results than in patients without the history of CABG.
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References
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