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Sharp Drop in Emergency Bypass After Angioplasty

But in-hospital mortality for emergency CABG surgery remains high

FRIDAY, Dec. 2 (HealthDay News) -- The number of percutaneous coronary intervention (PCI) patients requiring emergency coronary artery bypass grafting (CABG) dropped sharply from 1979 to 2003, but the mortality rate for emergency CABG has remained high and constant during that period, according to a study published in the Dec. 6 issue of the Journal of the American College of Cardiology.

Eric H. Yang, M.D., of the Mayo College of Medicine in Rochester, Minn., and colleagues analyzed data from 23,087 patients at the Mayo Clinic who underwent PCI from 1979 to 2003. They were divided into three groups according to date of procedure: pre-stent era (1979-1994, 8,905 patients); initial stent era (1995-1999, 7,605 patients); and current stent era (2000-2003, 6,577 patients).

Despite the fact that during more recent time periods there were a greater number of high-risk patients, there was a substantial drop in the number of patients requiring emergency CABG -- from 2.9% in the pre-stent group, 0.7% in the initial stent group and 0.3% in the current stent group. However, the mortality rate for emergency CABG patients remained unchanged at 10% to 14%.

"Although there has been a change in the characteristics and indications for emergency CABG, the in-hospital and one-year mortality rate for these patients remains the same, underscoring the need to recognize variables associated with higher incidence of emergent CABG, and tailor strategies to avoid or reduce such complication," the authors conclude.

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