CABG performed 2–7 days after STEMI reduced in-hospital mortality by 41.5% (OR 0.585) compared to <48 hours or ≥16 days groups, with lowest mortality and cost.
Does the timing of CABG following STEMI impact in-hospital mortality, length of stay, and costs?
Delaying CABG to 2-15 days after STEMI is associated with the lowest in-hospital mortality risk compared to early (<48 hours) or very late (≥16 days) surgery.
Absolute Event Rate: 0% vs 0%
Abstract OBJECTIVES Approximately 5–10% of STEMI patients will undergo coronary artery bypass grafting (CABG) during the same hospital admission. In this study, we analyze the time from STEMI to CABG and its impact on operative mortality, morbidity, hospital stay, and cost. METHODS The Healthcare Cost and Utilization Project (HCUP) was reviewed for STEMI patients who underwent CABG in the same hospitalization from 2016–2022. Patients were grouped by time from STEMI to CABG: 48 hours, 2–7 days, 8–15 days, and ≥16 days. Demographics, characteristics, mortality, length of stay, and cost were compared with univariable analysis. Multivariable logistic regression identified risk factors for in-hospital mortality. RESULTS HCUP database identified 11, 974 patients who underwent CABG following STEMI: 4882 48 hours (41%), 6110 in 2–7 days (51%), 896 in 8–15 days (7%), and 86 ≥ 16 days in (1%). Mortality was greatest when CABG performed 48 hours (6%) and ≥16 days (5%) compared to other groups 3% (2–7 days) v 3% (8–15 days), p. 01. Length of stay was greatest in ≥ 16 days (30 days) compared to other groups 7 days (48 hours) v 10 days (2–7 days) v 17 days (8–15 days), p 0. 01. Costs were also greatest in the ≥16 days (108, 400) compared to other groups (50, 400 (48 hours) v 55, 300 (2–7 days) v 73, 600 (8–15 days), p 0. 01). Multivariable regression identified 2–7 days STEMI to CABG decreased in-hospital mortality (OR 0. 585, CI95% 0. 48–0. 70). CONCLUSIONS CABG performed 2–15 days from STEMI provided the lowest in-hospital mortality risk, offering a window for the safest post-STEMI CABG when appropriate.
Crane et al. (Thu,) reported a other. CABG performed 2–7 days after STEMI reduced in-hospital mortality by 41.5% (OR 0.585) compared to <48 hours or ≥16 days groups, with lowest mortality and cost.