Brazilian Journal of Cardiovascular Surgery (Sep 2005)

Fatores preditores de infarto do miocárdio no período perioperatório de cirurgia de revascularização miocárdica Predictors of perioperative myocardial infarction in surgical myocardial revascularization

  • Cristiano Pederneiras Jaeger,
  • Renato A.K. Kalil,
  • João Carlos Vieira da Costa Guaragna,
  • João Batista Petrascco

DOI
https://doi.org/10.1590/S0102-76382005000300010
Journal volume & issue
Vol. 20, no. 3
pp. 291 – 295

Abstract

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OBJETIVOS: Determinar quais variáveis pré e transoperatórias são preditoras independentes de infarto do miocárdio (IAM) no período perioperatório de Cirurgia de Revascularização do Miocárdio (CRM), em um hospital geral da cidade de Porto Alegre, RS, Brasil. MÉTODO: Estudo de coorte retrospectivo com análise do banco de dados de cirurgia cardíaca do Hospital São Lucas da Pontifícia Universidade Católica do Rio Grande do Sul, com 1471 pacientes consecutivos que realizaram CRM com circulação extracorpórea (CEC), entre janeiro de 1998 e dezembro de 2002. RESULTADOS: Quatorze por cento dos pacientes da amostra apresentaram IAM perioperatório. As variáveis que se mostraram preditoras independentes para IAM perioperatório nesta amostra foram: reoperação (RC: 2,070 - p=0,036), lesão de tronco de coronária esquerda (TCE) (RC: 1,692 - p=0,006), sexo feminino (RC: 1,572 - p=0,034), angina instável pré-operatória (RC: 1,533 - p=0,011), maior número de enxertos (RC: 1,336 - p=0,001) e tempo de CEC prolongado (RC: 1,013 - pOBJECTIVE: To evaluate which preoperative and trans-operative variables are predictors for the occurrence of myocardial infarction in the perioperative period of surgical myocardial revascularization in a general hospital in Porto Alegre, Brazil. METHOD: A retrospective cohort study was made of the database of heart surgery in the Hospital São Lucas of the Pontifícia Universidade Católica in Rio Grande do Sul analyzing 1471 consecutive patients who underwent on-pump surgical myocardial revascularization from January 1998 to December 2002. RESULTS: Fourteen percent of the patients presented with perioperative myocardial infarction. The variables that proved to be independent predictors of perioperative myocardial infarction in surgical myocardial revascularization in this study were: prior surgical myocardial revascularization (OR: 2.070 - p=0.036), left main coronary artery lesion (OR: 1.692 - p=0.006), female (OR: 1.572 - p=0.034), preoperative unstable angina (OR: 1.533 - p=0.011), high number of grafts (OR: 1.336 - p=0.001) and prolonged cardiopulmonary bypass time (OR: 1.013 - p<0.001). CONCLUSIONS: Prior surgical myocardial revascularization, left main coronary artery lesion, female, preoperative unstable angina, high number of grafts and prolonged cardiopulmonary bypass time proved to be independent predictors of perioperative myocardial infarction in surgical myocardial revascularization in this study of patients from a general hospital from Porto Alegre, Brazil.

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