611 Influence of Timing of Cardiac Surgery on Acute Coronary Syndrome Outcomes in an Australian Setting

Abstract

The study aims to investigate the influence of the delay from diagnosis to CABG on outcomes. All patients 18 years and older with an acute presentation due to ACS or had critical coronary artery disease who were considered to require urgent inpatient cardiac surgery between Jan 2016- Feb 2019 were included in the study. The primary endpoints were 30-day all-cause mortality or readmission, 1-year all-cause mortality, all-cause readmission. The secondary endpoint was the rate of complications while waiting for surgery. The duration between diagnostic coronary angiography and surgery was considered as the time interval. Of the 266 patients, 251 underwent surgical revascularization with 15 (6%) not undergoing surgery due to preoperative complications or considered high risk surgical candidate (n=3). The majority (85%) were male (mean age 67 years), 37% of patients had diabetes, 71% had hypertension. NSTEMI patients were 51% of the patients. The median time between diagnosis and inpatient CABG was 7 days (IQR 5-11). Thirty-five percent had complications, 14% had 30-day all-cause readmission, 41% had 1-year all-cause readmission and 5% had 1-year all-cause mortality. Of the 266 patients, 140 patients (53% - cohort one) underwent surgery within 7 days. Cohort one rate of complications was lower than cohort two (surgery after 7 days) (24 vs 47%, p<0.001). Moreover, 1-year mortality was higher in cohort two (2 vs 8%, p=0.029). In patients requiring urgent inpatient CABG, delay for more than 7 days is associated with a higher rate of in-hospital complications and 12 month outcomes.