{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,21]],"date-time":"2026-10-21T18:24:50Z","timestamp":1792607090762,"version":"4.5.0"},"reference-count":23,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"18","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2021,9,21]]},"abstract":"<jats:sec xml:lang=\"en\">\n            <jats:title>Background<\/jats:title>\n            <jats:p xml:lang=\"en\">Coronary artery bypass grafting has remained an important treatment option for acute coronary syndromes, particularly in patients (1) with ongoing ischemia and large areas of jeopardized myocardium, if percutaneous coronary intervention (PCI) cannot be performed; (2) following successful PCI of the culprit lesion with further indication for coronary artery bypass grafting; and (3) where PCI is incomplete, not sufficient, or failed.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Methods and Results<\/jats:title>\n            <jats:p xml:lang=\"en\">\n              We aimed to analyze coronary artery bypass grafting outcome following prior PCI in acute coronary syndromes from the North\u2010Rhine\u2010Westphalia surgical myocardial infarction registry comprising 2616 patients. Primary end points were in\u2010hospital all\u2010cause mortality and major adverse cardio\u2010cerebral event. Patients were 68\u00b111\u00a0years of age, had 3\u2010vessel and left main\u2010stem disease in 80.4% and 45.3%, presenting a logistic EuroSCORE of 15.1% in unstable angina, 20.3% in non\u2013ST\u2010segment\u2013elevation myocardial infarction, and 23.5% in ST\u2010segment\u2013elevation myocardial infarction. A history of PCI was present in 36.2% and PCI was performed within 24\u00a0hours before surgery in 5.2% in unstable angina, 5.9% in non\u2013ST\u2010segment\u2013elevation myocardial infarction, and 16.1% in ST\u2010segment\u2013elevation myocardial infarction. PCI failed in 5.3% in unstable angina, 6.8% in non\u2013ST\u2010segment\u2013elevation myocardial infarction and 17.2% in ST\u2010segment\u2013elevation myocardial infarction, and 28.8% of patients presented with cardiogenic shock. In\u2010hospital mortality without PCI was 7.4%, but increased to 8.7% with prior PCI &gt;24\u00a0hours, 14.5% with prior PCI &lt;24\u00a0hours, and 14.1% with failed PCI (\n              <jats:italic>P<\/jats:italic>\n              &lt;0.003). The in\u2010hospital major adverse cardio\u2010cerebral event rate was 16.4% without PCI, but 17.4% with prior PCI &gt;24\u00a0hours, 25.6% with prior PCI &lt;24\u00a0hours, and 41.3% with failed PCI (\n              <jats:italic>P<\/jats:italic>\n              =0.014). Multivariable logistic regression analysis showed prior PCI (\n              <jats:italic>P<\/jats:italic>\n              =0.039), as well as failed PCI (\n              <jats:italic>P<\/jats:italic>\n              =0.001) to be predictors for in\u2010hospital all\u2010cause mortality and major adverse cardio\u2010cerebral event.\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p xml:lang=\"en\">In the current PCI era, immediately prior or failed PCI before coronary artery bypass grafting in acute coronary syndromes is associated with high perioperative risk, cardiogenic shock, and increased morbidity and mortality.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/jaha.121.021182","type":"journal-article","created":{"date-parts":[[2021,9,13]],"date-time":"2021-09-13T09:54:42Z","timestamp":1631526882000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":33,"title":["Coronary Artery Bypass Graft Surgery in Patients With Acute Coronary Syndromes After Primary Percutaneous Coronary Intervention: A Current Report From the North\u2010Rhine Westphalia Surgical Myocardial Infarction Registry"],"prefix":"10.1161","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1007-2871","authenticated-orcid":false,"given":"Matthias","family":"Thielmann","sequence":"first","affiliation":[{"name":"Department of Thoracic and Cardiovascular Surgery West\u2010German Heart and Vascular Center University of Duisburg\u2010Essen Essen 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