Optimal Timing of Coronary Artery Bypass Grafting in Hemodynamically Stable Patient After Myocardial Infarction and Definition of Poor Prognostic Factors. Pilot Study

NCT03863158 | Completed

• 1 other identifier: CCVT-ChloéBernard 2019
• Study Type: observational
• Target: 476
• Locations: 0 countries
• Sites: N/A

Brief Summary

Acute coronary syndromes (ACS) represent the leading cause of death in France. Their incidence is increasing due to population aging and to the persistence of cardiovascular risk factors. Currently, revascularization surgery remains outside the emergency treatment, because early performed, it tends to lead to extension and hemorrhage of the infarcted area, because of the CPB, aortic clamping, cardioplegia, and other heart manipulation. However, CABG are indicated as an emergency in some situations of STEMI: Threat of infarction of an extended territory without favorable anatomy to angioplasty, anatomy not favorable to angioplasty associated with cardiogenic shock or persistent ischemia, acute complications of myocardial infarction (massive mitral insufficiency, interventricular communication, parietal rupture) requiring surgery under CPB with concomitant bypass surgery or failure of angioplasty (proximal coronary dissection). Operative mortality is high; 15 to 20% for patients operated 12 to 48 hours after AMI and 4-5% for those operated after 48 hours. Nevertheless, it seems legitimate to study if there would be a place for primary surgical revascularization in case of patient with hemodynamically stable ACS, in order to limit myocardial ischemia, spread of necrosis, to limit the risk of recurrence, and the consequences of low cardiac output. Performing a complete early surgical revascularization could limit the ischemia-reperfusion syndrome and anticipate the occurrence of cardiogenic shock.

Conditions

Cardiac Surgery

Outcome Measures

Primary Outcomes (1)

• Correlation between the mortality rate and the delay between the surgical revascularization and the date of diagnosis of mycardial infaction in hemodynamically stable patients

  Delay in days between diagnosis and surgery

  30 days

Secondary Outcomes (1)

• Determine the predictors of intra-hospital mortality rate in hemodynamically stable patients operated of coronary bypass

  30 days

Interventions

No intervention OTHER

No intervention / medical records only

Eligibility Criteria

• Age: 18 Years - 99 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)
• Sampling Method: Non-Probability Sample

Study Population

Retrospective Observationnal study (medical records only) on patients undergoing CABG in emergency from the 2007 January 1 to 2018 december 31.

You may qualify if:

• Patients presenting acute myocardial infarction with hemodynamic stability at the diagnosis
• Patients undergoing coronary artery bypass in Dijon University hospital

You may not qualify if:

• Patients with Acute pulmonary oedema
• Patients with cardiorespiratory arrest before coronary angiography
• hemodynamically unstable patient at diagnosis
• patients requiring combined surgery
• patients with unstable angina

Sponsors & Collaborators

• Centre Hospitalier La Chartreuse: lead
• BOUCHOT Olivier: collaborator
• LAUBRIET-JAZAYERI Aline: collaborator

Study Design

• Study Type: observational
• Observational Model: COHORT
• Time Perspective: RETROSPECTIVE
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Principal investigator

Study Record Dates

• First Submitted: March 1, 2019
• First Posted: March 5, 2019
• Study Start: January 1, 2007
• Primary Completion: February 28, 2019
• Study Completion: February 28, 2019
• Last Updated: March 5, 2019

Record last verified: 2019-03

Data Sharing

• IPD Sharing: Will not share