Abstract
Objective: There is wide variations in practice about the exact timing
of coronary artery bypass grafting (CABG) post-acute myocardial
infarction (AMI) and admission to hospital. This study aims to review
current literature evidence to provide an up-to-date evaluation of the
optimal CABG timing and parameters indicative of patient outcomes.
Method: Electronic literature search was done to look into articles that
discussed acute myocardial presentation and their referral for CABG
either as urgent in-patient or as elective cases. The evidence was
synthesised based on each reported article and their outcomes. Results:
The timing of CABG following AMI have been explored in multiple studies,
however there is no clear consensus on when to proceed with CABG
following AMI and this remains controversial. The mortality rates vary
with timing of CABG, but confounding factors such as age, poor pulmonary
functions, renal insufficiency, poor left ventricular function and many
others can all contribute to the variable reported outcomes. Conclusion:
There is need for large, multi-centre study to identify optimal timings
for CABG in cases of complex coronary artery diseases or failed PCI in
patients with acute MI. Upcoming guidelines should emphasize patient
cohorts by taking their risk factors into consideration.