Two hundred twenty-seven consecutive patients had
chest pain and electrocardiographic, coronary angiographic, ventriculographic, and retrospective
enzyme changes consistent with acute evolving
myocardial infarction (
AEMI). These patients underwent
coronary artery bypass grafting an average of less than 6 hours after the start of
chest pain. The mean age was 55.8 years (range 28 to 79 years). Sex, coronary artery involvement, and preoperative and postoperative
enzymes and electrocardiograms are presented. Follow-up angiocardiograms done an average of 12.7 months postoperatively revealed 99 patent primary grafts in 102 patients (94.3%). Ejection fractions were normal, unchanged, or improved in 86.3% of the patients. Two ventricular
aneurysms measuring less than 2.5 cm in diameter were noted. Surgical in-hospital mortality was 1.76% and first-year mortality was 1.44%. Conventional
therapy in 200
AEMI patients treated at the same hospitals resulted in an in-hospital mortality of 11.5%. Follow-up of 213 patients having
coronary artery bypass grafting revealed that 14% had mild angina.
AEMI interrupted by
coronary artery bypass grafting early in the syndrome yields results which are superior to conventional management.