Patients with ST-elevation myocardial infarction (STEMI) and prior coronary artery bypass grafting (CABG) constitute a subgroup at high risk for morbidity and mortality compared with patients with STEMI without prior CABG. Primary percutaneous coronary intervention (PCI) has become the preferred treatment for patients with STEMI. It has been shown that, in patients with STEMI with prior CABG treated with primary PCI, treatment of a saphenous vein graft (SVG) is a more important predictor of outcome than a history of CABG alone.^1–3 Primary PCI for SVG occlusion is associated with poor procedural results and poor short- and long-term outcomes.³ The time to occurrence of STEMI due to SVG occlusion after CABG is unknown. Furthermore, it is unclear whether time from CABG affects the outcome of mechanical reperfusion for SVG occlusion. We evaluated the time from CABG to occurrence of STEMI due to SVG occlusion. Moreover, immediate angiographic outcome and 1-year mortality stratified to graft age after primary PCI for SVG occlusion were studied.

METHODS

Between January 1997 and March 2005, 3038 consecutive and unselected patients were treated for STEMI with primary PCI. A total of 37 (1.2%) patients were admitted with STEMI due to SVG occlusion and represent the study population. PCI was performed using standard techniques. All patients were treated with heparin and …