# Unveiling Cardiovascular Outcomes: A Comparative Analysis of CABG Recipients versus Non-CABG Patients in the Management of Acute Coronary Syndrome (ACS)

## TL;DR

This study compares cardiovascular outcomes in patients with and without a history of CABG surgery who have acute coronary syndrome.

## Contribution

The study identifies a higher risk of recurrent heart events in ACS patients with prior CABG surgery.

## Key findings

- CABG patients had significantly higher long-term risk of recurrent MI/ACS (P=0.001).
- Recurrent MI/ACS was also significantly higher in CABG patients compared to STEACS/NSTEACS controls (P=0.05).
- No significant differences were found in other in-hospital or long-term cardiovascular events.

## Abstract

Background: The history of bypass surgery for coronary arteries and subsequent
coronary angioplasty is a crucial and vital issue for patients with acute
coronary syndrome (ACS). This study aims to investigate and compare the
occurrence of cardiovascular events in patients with a history of Coronary
Artery Bypass Grafting (CABG) versus those without such a history, specifically
focusing on individuals diagnosed with ACS. Materials and Methods: This cohort
study was conducted at Madani Hospital in Tabriz, Iran. Patients diagnosed with
ACS who were hospitalized and underwent Percutaneous Coronary Intervention (PCI)
from the beginning of 2018 to the beginning of 2020 were included. The records
for follow-up regarding mortality and cardiovascular events were documented for
the next three years (2020 to 2023). Subsequently, patients were categorized
into two groups: those with a history of CABG and those without a history of
CABG. Patients of each study group were divided into two groups: ST-segment
elevation acute coronary syndrome (STEA)CS/primary PCI and non-ST-segment
elevation acute coronary syndrome (NSTEACS)/PCI, a total of approximately 473
cases were collected. The study groups were compared in terms of in-hospital and
long-term cardiovascular events as well as other clinical outcomes. Results: A
comparison of hospital and long-term events between the CABG group and the
control group demonstrated a significant difference only in cases of recurrent
myocardial infarction (MI)/ACS in long-term events (P=0.001). Additionally,
comparing hospital and long-term events in the CABG group and the STEACS/NSTEACS
control group revealed a significant difference only in cases of recurrent
MI/ACS in long-term events (P=0.05). Conclusion: Patients with a history of CABG
may face a higher risk of cardiovascular events, especially in recurrent MI/ACS.
A thorough examination and closer monitoring of this patient group are needed to
ensure improvement and mitigate the risks associated with potential
complications arising from previous CABG surgeries.