Acute myocardial infarction in patients who have had coronary artery bypass surgery

Background. Although acute myocardial infarction (AMI) and coronary artery bypass grafting (CABG) are frequently discussed, the issue of AMI in patients who have previously had CABG has not been addressed yet. Methods. We critically reviewed data obtained from the medical literature on this subject since 1974. Results. The overall incidence of AMI is about 10% during the first 3 years after CABG, though it occurs more frequently in older male patients. It seems that the infarct size is smaller and post-AMI ejection fraction is higher in patients who have had CABG than in those who have not. Although early mortality appears to be lower, on 5-year follow-up, more patients had AMI, angina, and revascularization procedures. Conclusions. The data abstracted indicate that AMI after CABG appears to be a well-delineated entity. Further studies are necessary to determine the optimal treatment for this population.