Impact of Previous Coronary Artery Bypass Grafting on Clinical Outcomes in Patients With Acute Myocardial Infarction: A Systematic Review and Meta-Analysis
Bibliographic record
Abstract
This systematic review and meta-analysis examined the impact of previous coronary artery bypass grafting (CABG) on clinical outcomes in patients presenting with acute myocardial infarction (AMI). A comprehensive literature search was conducted across PubMed/MEDLINE, Embase, Cochrane Central Register of Controlled Trials (CENTRAL), and Web of Science from January 2010 to August 2025, following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Observational studies comparing outcomes between patients with AMI with and without prior CABG history were included. Two independent reviewers performed study selection, data extraction, and quality assessment using the Newcastle-Ottawa Scale (NOS). Statistical analyses employed random-effects models using RevMan 5.4 (The Nordic Cochrane Centre, Copenhagen, Denmark) and R software (R Foundation for Statistical Computing, Vienna, Austria). Nine studies comprising patients with ST-segment elevation myocardial infarction (STEMI) and non-ST-segment elevation myocardial infarction (NSTEMI) were included in the final analysis. The pooled analysis demonstrated that previous CABG history was not significantly associated with all-cause mortality in the overall AMI population (relative risk (RR): 1.06, 95% confidence interval (CI): 0.97-1.16), although considerable heterogeneity was observed (I² = 87%). Subgroup analysis revealed that patients with STEMI with prior CABG had a 16% higher mortality risk compared to CABG-naïve patients (RR: 1.16, 95% CI: 1.12-1.20), while patients with NSTEMI showed a non-significant 6% increase (RR: 1.06, 95% CI: 0.95-1.19). No significant difference was found in major adverse cardiac events (MACE) between groups (RR: 0.98, 95% CI: 0.85-1.12). Meta-regression identified age, hypertension prevalence, and CABG prevalence as significant contributors to between-study heterogeneity. These findings suggest that prior CABG may confer increased mortality risk specifically in patients with STEMI, although limited study numbers in subgroup analyses warrant cautious interpretation and highlight the need for larger targeted investigations.
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How this classification was reachedexpand
Direct model labels (unvalidated)
Per-model category and study-design labels from the labeling rounds. They are machine output, unvalidated, and the disagreement between models ships as data. No study design here is MEDLINE-validated yet.
| Model arm | Categories | Study design | Confidence |
|---|---|---|---|
| gemma | no category Domain: not available · Genre: Review About the Canadian research system: no · About a Canadian topic: no | Meta-analysis | low |
| gpt | no category Domain: not available · Genre: Review About the Canadian research system: no · About a Canadian topic: no | Meta-analysis | medium |
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.015 | 0.036 |
| Meta-epidemiology (narrow) | 0.003 | 0.002 |
| Meta-epidemiology (broad) | 0.022 | 0.045 |
| Bibliometrics | 0.008 | 0.008 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.004 | 0.002 |
| Open science | 0.002 | 0.002 |
| Research integrity | 0.003 | 0.002 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedLabeled directly by 2 models reading the full record.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".