2015, Number 3
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Rev Cubana Cardiol Cir Cardiovasc 2015; 21 (3)
Prognostic evaluation in patients with ischemic heart disease treated with CABG
López RM, Nafeh Abi-Rezk M, Ramos VJ, Padilla OK, Valdés ÁJ, Almeida GJ, Jimenez PR
Language: Spanish
References: 15
Page:
PDF size: 269.94 Kb.
ABSTRACT
Introduction: Ischemic heart disease is among the major death causes in Cuba and also at world level; the coronary surgery is one of the pillar of its treatment.
Objective: To identify the indicator of adverse cardiac events and survival in patients treated by surgery of myocardial revascularization.
Method: A cohort longitudinal prospective study was conducted in the service of Cardiovascular Surgery of Cardiocenter of the "Hermanos Ameijeiras" Clinical Surgical Hospital from March, 2012 to March, 2013. The study universe included the total or patients presenting with ischemic heart disease and with criterion of myocardial revascularization by coronary surgery. The sample included 178 consecutive patients fulfilling the inclusion criteria. The variables response analyzed were: death by cardiac cause, non-fatal infarct, revascularization of target vessel, cerebrovascular accident, readmission, cardiac failure and major adverse event combined.
Results: The surgery with heartbeating was associated with a great incidence of adverse events, although not in a significantly. The anthropometric variables (abdominal circumference and waist/hip index) were associated in a significant way with the variables of response (p: 0.018 and p: 0.007, respectively). The patients having a low output, malignant arrhythmias and perioperative ischemia were associated with significantly with deat, non-fatal infarct and the need of revascularization of target vessel (
Chi2 = 9,392 , p = 0,002).
Conclusions: The indicators variables of adverse cardiac events and survival in patients treated by myocardial revascularization are: the support used in surgery, anthropometric variables and complications in the immediate postoperative period.
REFERENCES
Park DW, Seung KB, Kim YH. Long-term safety and effica-cy of stenting versus coronary artery bypass grafting for un-protected left main coronary artery disease: 5-year results from the MAIN-COMPARE (Revascularization for Unpro-tected Left Main Coronary Artery Stenosis: Comparison of Percutaneous Coronary Angioplasty Versus Surgical Revas-cularization) registry. J Am CollCardiol. 2010; 56:117-24.
Angelini GD, Taylor FC, Reeves BC y col: Early and mid-term outcome after off-pump and on-pump surgery in beating heart against cardioplegic arrest studies (BHACAS 1 and 2): a pooled analysis of two randomised controlled trials. Lancet 2008; 359.
Reston JT, Treggear SJ, Turkelson CM: Meta-analysis of short-term and mid-term outcomes following off-pump coro-nary artery bypass grafting. Ann ThoracSurg 2009; 76: 1510-1515.
Morlans K, Prado E, González-Prendes CM, García B, Rodríguez F, Santos J, et al. Disfunción neurológica en el posoperatorio inmediato de la cirugía cardiovascular: factores de riesgo, complicaciones asociadas, mortalidad y estadía. Rev Cubana CardiolCirCardiovasc 2009;13(2):142-8.
Colectivo de autores. Cirugía Coronaria. Hospital C. Q Her-manos Ameijeiras. Impacto de los resultados obtenidos en la asistencia, docencia e investigaciones. La Habana: Ed. Cien-ciasMédicas. 2008; p 210.
Carnero M, AlswiesA, Silva JÁ. Resultados de la cirugía co-ronaria sin circulación extracopórea tras angioplastia con stent. RevEspCardiol. 2009;62:520-7.
Parias Ángel M. Factores nutricionales preoperatorios con valor pronóstico de morbimortalidad en el postoperatorio precoz de cirugía cardiaca. RevMexzCard. 2010
Grupo de Trabajo de Revascularización Miocárdica de la So-ciedad Europea de Cardiología (ESC) y de la Asociación Eu-
ropea de Cirugía Cardiotorácica (EACTS). Desarrollada con la colaboración especial de la Asociación Europea de Inter-vencionismo Cardiovascular Percutáneo. Guía de práctica clínica sobre revascularización miocárdica. RevEspCardiol. 2010;63(12):1485.e1-e76
INTERHEART Study Invertigators. Obesity and the risk of myocardial infarction in 27000 participants from 52 coun-tries: a case-control study. Lancet. 2005;366:1640-9.
Iglesias P, Olivar J, Peñalver D. Impacto de la obesidad cen-tral en la extensión del área de necrosis miocárdica. Endocri-nolNutr. 2009;56(1):4-8.
Flint AJ, Rexrode K M, Hu FB, Glynn RJ. Body mass index, waist circumference, and risk of coronary heart disease: a prospective study among men and women. Obes Res Clin-Pract. 2010 JUL–SEP; 4(3): e171–e181.
Mendonça T, Moraes GM, Klein CH. Letalidad y Complica-ciones de la Cirugía de Revascularización Miocárdica en el Rio de Janeiro, de 1999 a 2003. ArqBrasCardiol 2010; 95(3): 303-312.
Vegni R, Almeida GF, Braga F, Freitas M, Drumond LE, Penna G, et al. Complicaçõesapóscirurgia de revascularizaç-ão do miocárdioem pacientes idosos. RevBras Ter Intens. 2008; 20 (3): 226-34.
Oviedo López A, López Valenzuela P, Martínez Hernández R. La cirugía de revascularización por toracotomía izquierda sin circulación extracorpórea, es una alternativa viable en la re-operación de puentes coronarios. ArcCardMex. 2008; 78 (3):299-304.