Clinical Characteristics and Outcomes of Patients With Myocardial Infarction and Cardiogenic Shock Undergoing Coronary Artery Bypass Surgery: Data From The Society of Thoracic Surgeons National Database
Outcomes of CABG for patients in cardiogenic shock after acute MI were evaluated using data from the STS Database. The study group of nearly 5,500 patients comprised 1.5% of all CABG patients during the study period. Operative mortality was 18.7%. Mechanical circulatory support use was most common in patients with more risk factors or high clinical acuity, and was associated with an operative mortality of 37.2% (preop and intraop use) and 58.4% (postoperative use only). CABG as salvage had an operative mortality of 53.3%.
It’s amazing how much cardiac surgery has changed given that only 1.5% of Cabg surgery in the US is done under these somewhat futile circumstances. That’s also a testament I suppose to modern coronary intensive care management that most post-MI patients have the luxury of “cooling off”, remodeling a bit and going on to semi-elective surgery. This data becomes even more important now because when we are faced with this situation, we can be transparent with patients, families and ourselves about what he data and results actually truly are. Nice paper.