LONGTERM RECURRENT ISCHEMIC CARDIOVASCULAR EVENTS AMONG PATIENTS WITH ST-SEGMENT ELEVATION MYOCARDIAL INFARCTION: INSIGHTS FROM THE AMI-QUÉBEC REGISTRY

Abstract

RESULTS: Results showed that 5608 obese patients underwent CABG during the study period. After propensity scoring, 494 patients receiving BIMA revascularization were matched to 5089 patients receiving single internal mammary artery (SIMA) revascularization. All pre-operative characteristics were comparable except for a higher prevalence of heart failure in the SIMA group. In-hospital post-operative mortality in the two groups was comparable (1.0% BIMA vs 1.8% SIMA, p1⁄40.86). In-hospital DSWI was also comparable (1.2% BIMA vs 1.0% SIMA, p1⁄40.63). However total DSWI (including post-discharge DSWI, median time 19 days) was significantly higher in the BIMA group compared to the SIMA group (3.6% vs 2.2%; p<0.0001). Over a median follow-up of 7.2 years (mean follow-up 7.7 4.2 years), there was no observed longterm survival advantage in the BIMA vs the SIMA group (p1⁄40.22). CONCLUSION: Using BIMA instead of SIMA increases the risk of DSWI in obese patients. The use of BIMA is not associated with better survival compared to the use of SIMA in this population. These results suggest that the increased short-term risk of post-operative infection associated with BIMA revascularization is not offset by a long-term survival benefit. Given the increased risk of DSWI and absence of midto long-term survival benefit, caution should be exerted when selecting the use of BIMA grafting in the obese population.