2015, Number 2
<< Back Next >>
Revista Cubana de Anestesiología y Reanimación 2015; 14 (2)
Risk factors associated with acute perioperative myocardial infarction in coronary artery bypass
Buitrago ECA, Cruz BR, Cabrera PAJ, Agüero MMO, Suárez LJM, Morales JE
Language: Spanish
References: 22
Page: 92-107
PDF size: 187.34 Kb.
ABSTRACT
Introduction: perioperative myocardial infarction is a complication with great impact in morbidity and mortality in cardiovascular anesthesia.
Objetive: Determine the posible risk factors associated to perioperative myocardial infarction in off-pump coronary artery bypass.
Methods: descriptive and cross-sectional study between September 2011-November 2012, in patients to whom myocardial revascularization without pump. The Odds Ratio value and confidence intervals of 95 % in patients with values of p ‹ 0.05 were considered to have a significant stadistical correlation.
Results: this study included 210 patients (75.2% men), mean age 62.3 ± 8.7 years, from these 30 with perioperative myocardial infartion. Patients with
advanced age (OR 14.5; IC 95 %: 5.9-35.1), functional class IV of NYHA (OR 3.2; IC 95 %: 1.2-9.3), chronic renal failure (OR 6.8; IC 95 %: 1.6-28.7), pulmonary
obstructive chronic disease (OR 4.5; IC 95 %: 1.9-10.4), diabetes mellitus tipe 1 (OR 7.1; IC 95 %: 3.1-16.3), tobacco addiction (OR 6.3; IC 95 %: 2.7-14.2), recent myocardial infarction (OR 6.6; IC 95 %: 1.3-34.2), FeVI ≤ 40% (OR 2.5; IC 95%: 1.1-5.7), unstable angina (OR 2.5; IC 95%: 1.1-6.2), heart failure (OR 27.5; IC 95%: 2.9-256.1) and coronary complex disease (OR 12.6; IC 95%: 5.2-30.7) showed a significant association with the presence of perioperative myocardial infarction. Patients without β blocker have 3 times as much of suffer
myocardial infarction. Complications were significantly greater in these group, with a mortality of 23%.
Conclusions: the coexistents diseases that showed association with the presence of perioperative myocardial infarction, with a significant increase in them complications and mortality.
REFERENCES
Go AS. Executive summary: Heart disease and stroke statistics- 2013 update: a report from the American Heart Association. Circulation. 2013;127:143-52.
Agüero MO, Cruz BR, Cabrera PA, Suárez LJ, Pérez M. Procedimiento quirúrgico de revascularización miocárdica sin circulación extra-corpórea: Antecedentes. Cuidados anestésicos. Rev Cubana Anest Reanim. 2008;7(2). En línea. Consultado 14/10/2012. Disponible en: http://bvs.sld.cu/revistas/scar/indice.htm/
Buchanan GL, et al. Elección de intervención coronaria percutánea o bypass en la enfermedad coronaria multivaso. Rev Esp Cardiol. 2013. En línea. Consultado 21/12/2013. Disponible en: http://dx.doi.org/10.1016/j.recep.2013.08.017/
Cabrera AJ, Cruz BR, Suárez J. Anestesia en Cirugía Cardiaca: En Guevara LA: Cirugía Cardiovascular. 1ra ed. Tomo II. La Habana; 2009. pp. 20-52.
Bueno González AM, Pérez Vela JM. Diagnóstico y Alternativas terapéuticas en la isquemia miocárdica aguda perioperatoria en Cirugía Coronaria. Med Intensiva. 2010;34(1):64-73.
Kushner FG. Guidelines for the management of patients with Myocardial infarction. Circulation. 2009;120(22):9-22.
Peix GA. Isquemia miocárdica y enfermedad coronaria microvascular. Rev Cubana Cardiol Cir Cardiovasc. 2010;16(3):264-75.
Muñoz CY, Vázquez RJ. Variables preoperatorias presentes en pacientes con cirugía coronaria sin circulación extracorpórea y su relación con la evolución posquirúrgica precoz. Corsalud. 2010;2(4):211-20.
Podgoreanu O, et al. Inflamatory gene polymorphisms and risk of postoperative myocardial infarction after cardiac surgery. Circulation. 2006;114(1):275-81.
Thygesen K, Alpert JS, Jaffe A. Third universal definition of myocardial infarction: expert consensus document: ESC/ACCF/AHA/WHF JACC 2012;60(10): En línea. Consultado: 10/01/14. Disponible en: http://dx.doi,org/10.1016/j.jac.2012.08.001/
Buffolo E. Off-pump myocardial revascularization: critical analysis of years experience in 3 866 patients. Ann Thorac Surg. 2006;81:85-9.
Grau M. Grosor íntima-media carotideo: valores de referencia y asociación con los factores de riesgo cardiovascular. Rev Esp Cardiol. 2012;65(12):1086-93.
Yau TM. Predictor’s operative risk for coronary bypass operations in patients with left ventricular disfunction. J Thorac Surg. 2010;79:837-45.
Fernández García A, Silveira A, Milán E. Factores asociados a infarto agudo de miocardio perioperatorio en cirugía cardíaca. Rev Fed Arg Cardiol. 2012;41(2):103-8.
Serrano R. La hipercolesterolemia familiar es la principal causa prevenible y tratable de IMA en pacientes jóvenes. Rev Esp Cardiol. 2008;61(2):124-8.
Santos M, Valdivia E, et al. Factores de riesgo en el infarto agudo del miocardio en menores de 50 años. Rev Cubana Cardiol Cir Cardiovasc. 2012;18(3):149-52.
Mancia G, Fagard R. Guía de práctica clínica de la ESH/ESC 2013 para el manejo de la hipertensión arterial. Rev Esp Cardiol. 2013;66(10):880. e1-880. e64. En línea. Consultado. 15/12/13. Disponible en: http://www.revespcardiol.org el 02/11/2013.
Reich D. Perioperative interventions to modify risk of morbidity and mortality. Sem Cardioth Vasc Anaesth. 2007;11:224-30.
Puig M. Función plaquetaria e hiperglucemia en el síndrome coronario. Rev Esp Cardiol. 2013. En línea. Consultado: 16/12/13. Disponible en: http://dx.doi.org/10.1016/j.recesp.2013.08.012.
Alberts MJ, Bhatt DL, Mas JL. Reduction of Atherothrombosis for Continued Health (REACH) Registry Investigators. Three-year follow-up and event rates in the international Reduction of Atherothrombosis for continued Health Registry. Eur Heart J. 2009;30:2318-26.
Coleman MD, Shaefi S, Sladen RN. Preventing acute kidney injury after cardiac surgery. Curr Opin Anaesthesiol. 2011;24(1):70-6.
Kaskia JC, Arrebola ML. Inflamación y trombosis en la fibrilación auricular aguda". Rev Esp Cardiol. 2011;64(7):551-3.