Skip Navigation


European Heart Journal Advance Access originally published online on April 3, 2009
European Heart Journal 2009 30(12):1450-1456; doi:10.1093/eurheartj/ehp102
This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow Supplementary Data
Right arrow All Versions of this Article:
30/12/1450    most recent
ehp102v1
Right arrow E-letters: Submit a response
Right arrow Alert me when this article is cited
Right arrow Alert me when E-letters are posted
Right arrow Alert me if a correction is posted
Services
Right arrow Email this article to a friend
Right arrow Related articles in EHJ
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to My Personal Archive
Right arrow Download to citation manager
Right arrow Search for citing articles in:
ISI Web of Science (1)
Right arrowRequest Permissions
Right arrow Disclaimer
Google Scholar
Right arrow Articles by Berry, C.
Right arrow Articles by McMurray, J. J.V.
PubMed
Right arrow PubMed Citation
Right arrow Articles by Berry, C.
Right arrow Articles by McMurray, J. J.V.
Social Bookmarking
Add to CiteULike   Add to Connotea   Add to Del.icio.us  
What's this?

Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2009. For permissions please email: journals.permissions@oxfordjournals.org

Patients with prior coronary artery bypass grafting have a poor outcome after myocardial infarction: an analysis of the VALsartan in acute myocardial iNfarcTion trial (VALIANT)

Colin Berry1, Karen S. Pieper2, Harvey D. White3, Scott D. Solomon4, Frans Van de Werf5, Eric J. Velazquez2, Aldo P. Maggioni6, Robert M. Califf2, Marc A. Pfeffer4 and John J.V. McMurray1,*

1 Faculty of Medicine, BHF Cardiovascular Research Centre, University of Glasgow, Glasgow, G12 8TA Scotland, UK
2 Duke Clinical Research Institute, Duke University Medical Center, Durham, NC, USA
3 Green Lane Cardiovascular Service, Auckland, New Zealand
4 Brigham and Women's Hospital, Boston, MA, USA
5 University Hospital Gasthuisberg, Leuven, Belgium
6 ANMCO Research Center, Florence, Italy

Received 18 November 2008; revised 29 January 2009; accepted 25 February 2009; online publish-ahead-of-print 3 April 2009.

* Corresponding author. Tel: +44 141 330 3479, Fax: +44 141 330 6955, Email: j.mcmurray{at}bio.gla.ac.uk

See page 1429 for the editorial comment on this article (doi:10.1093/eurheartj/ehp170)

Aims: The number of patients presenting with an acute myocardial infarction (MI) and prior coronary artery bypass grafting (CABG) is increasing. We compared the baseline characteristics, treatment, and clinical outcomes of patients with and without prior CABG in the VALIANT trial.

Methods and results: Of the 14 703 patients with heart failure (HF), left ventricular systolic dysfunction, or both enrolled in VALIANT, 1026 (7%) had prior CABG. Prior CABG patients were older [mean age (SD): 67 (10) vs. 65 (12) years; P < 0.0001], had more comorbidity, and more frequent non-Q wave MI (66 vs. 30%; P < 0.0001). At hospital presentation, prior CABG patients received less aspirin (82 vs. 90%; P < 0.0001) and thrombolysis (21 vs. 36%; P < 0.0001), but had a similar rate of primary percutaneous coronary intervention (14 vs. 15%; P = 0.2). Prior CABG patients were more likely to experience the composite outcome of cardiovascular death, MI, HF, resuscitated cardiac arrest, or stroke; 3 year Kaplan–Meier rate, 64 vs. 39% (adjusted hazard ratio 1.29, 95% confidence interval 1.17–1.43; P < 0.0001).

Conclusion: Patients with prior CABG had a worse clinical profile and experienced more fatal and non-fatal outcomes. Greater recognition is necessary for these high-risk patients including optimization of evidence-based secondary preventive therapy.

Key Words: Coronary artery disease • Myocardial infarction • Coronary artery bypass graft • Prognosis


Add to CiteULike CiteULike   Add to Connotea Connotea   Add to Del.icio.us Del.icio.us    What's this?

Related articles in EHJ:

Are adapted guidelines required for patients with prior bypass surgeries and heart failure in acute myocardial infarction?
Aris Moschovitis and Bernhard Meier
EHJ 2009 30: 1429-1430. [Extract] [Full Text]  



This article has been cited by other articles:


Home page
 Eur Heart JHome page
A. Moschovitis and B. Meier
Are adapted guidelines required for patients with prior bypass surgeries and heart failure in acute myocardial infarction?
Eur. Heart J., June 2, 2009; 30(12): 1429 - 1430.
[Full Text] [PDF]


Disclaimer: Please note that abstracts for content published before 1996 were created through digital scanning and may therefore not exactly replicate the text of the original print issues. All efforts have been made to ensure accuracy, but the Publisher will not be held responsible for any remaining inaccuracies. If you require any further clarification, please contact our Customer Services Department.