Prognostic evaluation in patients with ischemic heart disease treatment with revascularization myocardial surgery

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.

Keywords

• cirugía de revascularización miocárdica, pronóstico, cardiopatía isquémica, eventos adversos.