2015, Number 4
Association of left ventricular systolic dysfunction with subsequent cardiac events in coronary artery bypass surgery
Language: Spanish
References: 13
Page:
PDF size: 367.29 Kb.
ABSTRACT
Background: Systolic heart failure is a prognostic factor for several adverse clinical situations.Proposal: to determine if left ventricular systolic dysfunction is associated with cardiac events after coronary artery bypass surgery.
Method: a prospective, longitudinal and observational study with 130 revascularizated patients by coronary artery bypass surgery since the reopening of this activity at 2010 at the Cardiovascular Institut was done. Evolution of patients until 12 months after surgery was determined by external consults and phone calls. Population of the study was divided in two groups: with left ventricular ejection fraction more than 45% (119 patients) and less or equal of 45% (11 patients) for statystical. Chi square and t-student was used to compare qualitatives and quantitatives variables respectively. Probability of survival free of events was determined by Kaplan-Meier test and comparison between groups by Cox-Mantel test.
Results: previous myocardial infarction (p=0.02), higher endiastolic and endsytolic diameters(p=0.00) and higher creatinin levels were more frequent in the group of patients with ejection fraction less than 45%. There were differences between both groups according to the incidence of intra-hospital cardiac events (p=0.008) and cardiac mortality (p=0.03). Survival probability without cardiac events at 12 months was less in patients with ejection fraction less than 45%.
Conclusion: preoperative left ventricular systolic dysfunction is associated with a higher intra-hospital cardiac mortality.
REFERENCES
Zishiri ET, Williams S, Cronin EM, Blackstone EH, Ellis SG, Roselli EE et al. Early Risk of Mortality After Coronary Artery Revascularization in Patients With Left Ventricular Dysfunction and Potential Role of the Wearable Cardioverter Defibrillator. Circ Arrhythm Electrophysiol. 2013[citado9 Sept 2015];6:117-128. Disponible en: http://circep.ahajournals.org/content/6/1/117.full.pdf+html
Shahian DM, O’Brien SM, Sheng S, Grover FL, Mayer JE, Ja-cobs JP et al. Predictors of long-term survival after coronary ar-tery bypass grafting surgery: results from the Society of Tho-racic Surgeons Adult Cardiac Surgery Database (the ASCERT study). Circulation 2012[citado9 Sept 2015];125:1491–1500. Disponible en: http://circ.ahajournals.org/content/125/12/1491.full.pdf+html
Nagendran J, Norris CM, Graham MM, Ross DB, Ross DB, MacArthur RG, Kieser TM et al. Coronary Revascularization for Patients with Severe Left Ventricular Dysfunction. Ann Thorac Surg 2013[citado9 Sept 2015]; 96:2038–44. Disponible en: http://www.annalsthoracicsurgery.org/article/S0003-4975%2813%2901380-5/pdf