What is the clinical evidence from this study?

Study design: Cohort. Population: Emergency surgery of the aorta (n=122). Intervention: Coronary angiography vs. No coronary angiography. Primary outcome: In-hospital mortality (p=0.46).

What question did this study set out to answer?

To assess whether performing preoperative coronary angiography affects in-hospital mortality in patients undergoing emergency aortic surgery without prior coronary revascularization or catheterization.

May 13, 2026Journal of the American College of Cardiology

Does coronary angiography before emergency aortic surgery affect in-hospital mortality?

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Key result

Preoperative coronary angiography shows no in-hospital mortality benefit before emergency aortic surgery.

P=0.46
n=122

Why the study?

The benefits of coronary angiography before emergency aortic surgery must be weighed against risks of surgical delay, but its impact on in-hospital mortality is unclear.

Does coronary angiography before emergency aortic surgery reduce in-hospital mortality in patients without prior coronary revascularization or angiography?

Key Points

To assess whether performing preoperative coronary angiography affects in-hospital mortality in patients undergoing emergency aortic surgery without prior coronary revascularization or catheterization.
Retrospective cohort analysis of N=122 patients who underwent emergency aortic surgery between January 1982 and December 1997 at the Cleveland Clinic Foundation.
Data extracted from patient medical charts and the Cardiovascular Information Registry (CVIR) to compare outcomes based on receipt of same-day coronary angiography.
Overall in-hospital mortality was 18.0%, with no significant difference between patients who had angiography on the day of surgery and those who did not (22% [n=41] vs. 16% [n=81], p=0.46).
Multivariate analysis identified a history of myocardial infarction as the sole predictor of in-hospital mortality (RR: 4.98, 95% CI: 1.48–16.75, p=0.009), though coronary angiography did not alter mortality within this subgroup.
Coronary angiography did not significantly alter the rate of concurrent coronary artery bypass grafting (CABG) (17% vs. 25%), and 74% of CABG procedures were prompted by coronary dissection rather than coronary artery disease.

Study Design

Type

Cohort (n=122)

Multicenter

Structured PICO

Does coronary angiography before emergency aortic surgery reduce in-hospital mortality in patients without prior coronary revascularization or angiography?

Population

122 patients undergoing emergency surgery of the aorta without a history of coronary revascularization or prior coronary angiography.

Exposure

Coronary angiography on the day of surgery

Comparator

No coronary angiography on the day of surgery

Outcome

In-hospital mortalityhard clinical

Main Result

Absolute Event Rate: 22% vs 16%

p-value: p=0.46

Discussion

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Implication

Coronary angiography before emergency aortic surgery does not improve in-hospital mortality, supporting the strategy of proceeding directly to surgery without delay.

Cite This Study

Penn et al. (2000) conducted a cohort in Emergency surgery of the aorta (n=122). Coronary angiography vs. No coronary angiography was evaluated on In-hospital mortality (p=0.46). Coronary angiography before emergency aortic surgery did not significantly affect in-hospital mortality compared to no angiography (22% vs 16%; p=0.46).

synapsesocial.com/papers/6a0441fe151c485067848be8 https://doi.org/10.1016/s0735-1097(99)00638-5

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Implication

Coronary angiography before emergency aortic surgery does not improve in-hospital mortality, supporting the strategy of proceeding directly to surgery without delay.

Does coronary angiography before emergency aortic surgery affect in-hospital mortality?

Key Points

Study Design

Structured PICO

Main Result

Discussion

Implication

Cite This Study

Does coronary angiography before emergency aortic surgery affect in-hospital mortality?

Key Points

Study Design

Structured PICO

Main Result

Discussion

Implication

Cite This Study

Also Consider

Also Consider