Recent data combined from the National Cardiovascular Data Registry CathPCI Registry and ACTION Registry-GWTG have identified a longer treatment time for heart attack patients when they have had a history of previous coronary artery bypass graft surgery. The results from this study were published in JACC: Cardiovascular Interventions.
Out of 15,628 heart attack patients treated at various United States hospitals over two years, 75 percent had no history of heart procedures, 19 percent had previous angioplasty, a procedure to restore blood flow through the artery (MedlinePlus
), and 6 percent had a history of previous coronary artery bypass graft surgery. During this procedure, surgeons redirect blood flow by connecting a healthy artery to detour the blocked artery (National Heart, Lung, and Blood Institute
Scientists from the American College of Cardiology analyzed the variance in door-to-balloon times, a measurement indicated the time between the arrival of a heart attack patient to the hospital and the time at which the patient received percutaneous coronary intervention (American Heart Association
12.5 percent less of the patients with a history of previous coronary artery bypass were treated with the recommended 90-minute door-to-balloon time than patients with previous angioplasty or patients with no history of heart procedures. In addition, six percent less of the patients with the previous surgery had successful procedures completed than the other two groups. However, the data did not report statistically significant differences between groups in “in-hospital mortality, major adverse events, and major bleeding.”
Luis Gruberg, MD, and lead author of the study which was published in the journal JACC: Cardiovascular Interventions,
acknowledged both the “more complex anatomy and more comorbidities” of patients with previous coronary bypass surgery and the importance of making “every effort” to treat them as fast as other patients regardless of their condition.
On average, patients with previous coronary artery bypass graft surgery are older and more likely to have other preexisting conditions like hypertension, high cholesterol and diabetes.
John S. Douglas Jr., MD, interpreted the Gruberg’s study as a “call to action with the goal of earliest possible treatment in all heart attack patients.”
Watch the following video to learn more about percutaneous coronary intervention.
Source: American College of Cardiology