[Trends of risk factors in coronary surgery].

Abstract

INTRODUCTION:

In current era of widespread use of percutaneous coronary interventions (PCI), it is debatable whether coronary artery by-pass graft (CABG) patients are at higher risk.

OBJECTIVE:

The aim of the study was to evaluate trends in risk profile of isolated CABG patients.

METHODS:

By analysing the EuroSCORE and its risk factors, we reviewed a consecutive group of 4675 isolated CABG patients, operated on during the last 8 years (2001-2008) at our Clinic. The number of PCI patients was compared to the number of CABG patients. For statistical analyses, Pearson's chi-square and ANOVA tests were used.

RESULTS:

The number of PCI increased from 159 to 1595 (p < 0.001), and the number of CABG from 557 to 656 (p < 0.001). The mean EuroSCORE increased from 2.74 to 2.92 (p = 0.06). The frequency of the following risk factors did not change over years: female gender, previous cardiac surgery, serum creatinine > 200 micromol/l, left ventricular dysfunction and postinfarct ventricular septal rupture. Chronic pulmonary disease, neurological dysfunction, and unstable pectoral angina declined significantly (p < 0.001). Critical preoperative care declined from 3.1% in 2001 to 0.5% in 2005, than increased and during the last 3 years did not change (2.3%). The mean age increased from 56.8 to 60.7 (p < 0.001) and extracardiac arteriopathy increased from 9.2% to 22.9% (p < 0.001). Recent preoperative myocardial infarction increased from 11% to 15.1% (p = 0.021), while emergency operations increased from 0.9% to 4.0% (p = 0.001).

CONCLUSION:

The number of CABG increases despite the enlargement of PCI. The risk for isolated CABG given by EuroSCORE increases over years. The risk factors, significantly contributing to higher EuroSCORE are: older age, extracardiac arteriopathy, recent myocardial infarction and emergency operation.

• Authors: Bogoljub Mihajlović, Svetozar Nićin, Nada Cemerlić-Adjić, Katica Pavlović, Slobodan Dodić, Lazar Velicki, Miklos Fabri
• Journal: Srpski arhiv za celokupno lekarstvo (Srp Arh Celok Lek) 2010 Sep-Oct Vol. 138 Issue 9-10 Pg. 570-6 ISSN: 0370-8179 [Print] Serbia
• PMID: 21180086 (Publication Type: Journal Article)

Topics

• Angioplasty, Balloon, Coronary (adverse effects, statistics & numerical data)
• Coronary Artery Bypass (adverse effects, statistics & numerical data)
• Female
• Humans
• Male
• Middle Aged
• Risk Factors