Timing of coronary artery bypass grafting in patients with myocardial infarction. Is the earlier the better?

Abstract

Objective: To study the optimal timing of Coronary artery bypass grafting (CABG) after acute myocardial infarction (MI). Study Design: Retrospective Cross-sectional study. Setting: Punjab Institute of Cardiology, Lahore. Period: January 2019 to January 2023. Material & Methods: Patients who underwent on pump CABG grafting after MI were included in the study and divided into those who had surgery within 7 days (early surgery group) and those who had surgery after 7 days (late surgery group). Those with additional cardiac procedures, operated in emergency and those who underwent redo procedures were excluded from the study. Patients were followed for 30 days. Data was collected on pre-formed proformas and analyzed using IBM SPSS software (version 23, SPSS Inc., Chicago, IL, USA). Results: A total of 475 patients ((early surgery group, 224), (late surgery group, 251) were included in the study. Mean age was 52.75 ± 7.7 years. NSTEMI was significantly more in patients with early surgery (161) (71.9%) compared to 99 (39.3%) in the late group (p= 0.01). Intraoperatively, cross clamp time and bypass time was similar in both the groups (p=0.81 and 0.15 respectively). Mortality was (1.3%) in the early surgery group and 3 (1.2%) in the late operation group. Conclusion: Patients who suffered from myocardial infarction can undergo surgery after the acute phase with acceptable mortality and morbidity compared to those operated late.