Current risk of coronary bypass for unstable angina

S. E. Fremes, B. S. Goldman, G. T. Christakis, J. Ivanov, R. D. Weisel, Tomas Salerno, T. E. David, Cardiovascular Surgeons of the University of Toronto the Cardiovascular Surgeons of the University of Toronto

Research output: Contribution to journalArticle

26 Citations (Scopus)

Abstract

The risk associated with surgical revascularization for unstable angina is critically dependent upon the clinical presentation of the patient. For this study, between January 1982 and December 1987, clinical, angiographic, operative and hospital outcome data were collected prospectively for 6539 patients undergoing surgery for unstable angina. Urgent surgery was performed in 1523 patients (23.3%), while 5016 (76.7%) underwent semielective revascularization. The mean age was 58.9±9.2 years and 805 patients (12.3%) were aged 70 years or above. The male: female ratio was 3.6:1. Depressed left ventricular function (left ventricular ejection fraction <40%) was present in 27.2% of the population. Preoperative myocardial infarction (within 30 days of surgery) had occurred in 588 patients (9.0%). Operative mortality was 4.6% (301 deaths). Stepwise logistic regression analysis was performed to determine the independent predictors of operative mortality. The following variables were selected in descending order: urgent surgery (P<0.001), coronary reoperation (P<0.001), depressed left ventricular (P<0.001), female gender (P<0.001), increasing age (P<0.001), left main stenosis (P=0.002), and preoperative myocardial infarction (P<0.001). Predicted operative mortality varied between 0.5±0.3% and 82.6±12.7%. The most important determinant for patients with a preoperative myocardial infarction was left ventricular dysfunction, whereas urgent surgery for unstable angina was the most important risk variable in those without preoperative necrosis.

Original languageEnglish
Pages (from-to)235-243
Number of pages9
JournalEuropean Journal of Cardio-thoracic Surgery
Volume5
Issue number5
StatePublished - Dec 1 1991
Externally publishedYes

Fingerprint

Unstable Angina
Myocardial Infarction
Mortality
Left Ventricular Dysfunction
Ambulatory Surgical Procedures
Reoperation
Left Ventricular Function
Stroke Volume
Pathologic Constriction
Necrosis
Logistic Models
Regression Analysis
Population

Keywords

  • Operative mortality
  • Unstable angina

ASJC Scopus subject areas

  • Surgery
  • Cardiology and Cardiovascular Medicine

Cite this

Fremes, S. E., Goldman, B. S., Christakis, G. T., Ivanov, J., Weisel, R. D., Salerno, T., ... the Cardiovascular Surgeons of the University of Toronto, C. S. O. T. U. O. T. (1991). Current risk of coronary bypass for unstable angina. European Journal of Cardio-thoracic Surgery, 5(5), 235-243.

Current risk of coronary bypass for unstable angina. / Fremes, S. E.; Goldman, B. S.; Christakis, G. T.; Ivanov, J.; Weisel, R. D.; Salerno, Tomas; David, T. E.; the Cardiovascular Surgeons of the University of Toronto, Cardiovascular Surgeons of the University of Toronto.

In: European Journal of Cardio-thoracic Surgery, Vol. 5, No. 5, 01.12.1991, p. 235-243.

Research output: Contribution to journalArticle

Fremes, SE, Goldman, BS, Christakis, GT, Ivanov, J, Weisel, RD, Salerno, T, David, TE & the Cardiovascular Surgeons of the University of Toronto, CSOTUOT 1991, 'Current risk of coronary bypass for unstable angina', European Journal of Cardio-thoracic Surgery, vol. 5, no. 5, pp. 235-243.
Fremes SE, Goldman BS, Christakis GT, Ivanov J, Weisel RD, Salerno T et al. Current risk of coronary bypass for unstable angina. European Journal of Cardio-thoracic Surgery. 1991 Dec 1;5(5):235-243.
Fremes, S. E. ; Goldman, B. S. ; Christakis, G. T. ; Ivanov, J. ; Weisel, R. D. ; Salerno, Tomas ; David, T. E. ; the Cardiovascular Surgeons of the University of Toronto, Cardiovascular Surgeons of the University of Toronto. / Current risk of coronary bypass for unstable angina. In: European Journal of Cardio-thoracic Surgery. 1991 ; Vol. 5, No. 5. pp. 235-243.
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