Journal of Shandong University (Health Sciences) ›› 2025, Vol. 63 ›› Issue (5): 60-70.doi: 10.6040/j.issn.1671-7554.0.2024.0961

• Special Topic on Application of Arterial Grafts in Coronary Artery Bypass Grafting • Previous Articles    

A Meta-analysis of the timing of coronary artery bypass grafting surgery for acute non-ST myocardial infarction

WEN Xuelong1, LIU Anhui1, CHEN Jingwei2, WU Mengting2, YANG Min2   

  1. 1. Wuxi School of Medicine, Jiangnan University, Wuxi 214122, Jiangsu, China;
    2. Department of Cardiovascular Surgery, Affiliated Hospital of Jiangnan University, Wuxi 214122, Jiangsu, China
  • Published:2025-05-07

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Abstract: Objective To investigate the influence of the time interval of coronary artery bypass grafting(CABG)on the clinical outcomes of patients who suffered from acute non-ST elevated myocardial infarction(NSTEMI). Methods CNKI, PubMed, Web of Science, Cochrane Library and Google Scholar were searched. The search time of the databases was from the establishment of the database to July 2024. Meta-analysis was performed using RevMan 5.4 software and patients were divided into 3 subgroups according to the time interval from diagnosis of NSTEMI to CABG at 1 day, 3 days, and 7 days, respectively, namely the early group(<1 d,<3 d,<7 d)and the delayed group(>1 d,>3 d,>7 d). The primary outcome measure was all-cause mortality during hospitalization, and the secondary outcome measure was the incidence of recurrent myocardial infarction and stroke during perioperative period. Results A total of 13 studies were included, containing 6 retrospective studies and 7 database studies, involving 657 555 patients. Among them, 10 studies compared the impact of CABG within 1 day and after 1 day in NSTEMI patients on patient outcome indicators, 6 studies sorted out the effects of CABG within 3 days and CABG after 3 days in NSTEMI patients on patient outcome indicators, 3 studies examined the effects of CABG within 7 days and CABG after 7 days on outcomes in NSTEMI patients. Meta analysis showed that compared with the delayed group, the all-cause mortality rate was higher in the early 1-day group(OR=1.58, 95%CI:1.09-2.30, P=0.02),and the difference was statistically significant. The risk of perioperative recurrence of myocardial infarction(OR=0.61, 95%CI:0.28-1.33, P=0.21)and stroke(OR=0.95, 95%CI: 0.58-1.55, P=0.82)were lower, but the difference was not statistically significant. There was no statistically significant difference in the all-cause mortality(OR=1.01, 95%CI:0.73-1.41, P=0.95), perioperative recurrence of myocardial infarction(OR=0.89, 95%CI:0.36-2.18, P=0.79)and stroke(OR=1.59, 95%CI:0.80-3.17, P=0.19)risks between the early 3-day group and the delayed group. There was no statistically significant difference in the all-cause mortality rate between the early 7-day group and the delayed group(OR=1.14, 95%CI: 0.63-2.08, P=0.67), and perioperative recurrence of myocardial infarction and stroke were not included as outcome indicators. Conclusion The risk of CABG operation within 1 day in acute NSTEMI patients was higher than that in the delayed group. CABG for NSTEMI patients should be postponed after 1 day if possible.

Key words: Acute non-ST elevation myocardial infarction, Coronary artery bypass grafting, Early surgery, Delayed operation, Systematic review, Meta-analysis

CLC Number: 

  • R654
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