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 language | English |
|---|---|
| Pages (from-to) | 235-243 |
| Number of pages | 9 |
| Journal | European Journal of Cardio-thoracic Surgery |
| Volume | 5 |
| Issue number | 5 |
| State | Published - Dec 1 1991 |
| Externally published | Yes |
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Keywords
- Operative mortality
- Unstable angina
ASJC Scopus subject areas
- Surgery
- Cardiology and Cardiovascular Medicine
Cite this
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 journal › Article
}
TY - JOUR
T1 - Current risk of coronary bypass for unstable angina
AU - Fremes, S. E.
AU - Goldman, B. S.
AU - Christakis, G. T.
AU - Ivanov, J.
AU - Weisel, R. D.
AU - Salerno, Tomas
AU - David, T. E.
AU - the Cardiovascular Surgeons of the University of Toronto, Cardiovascular Surgeons of the University of Toronto
PY - 1991/12/1
Y1 - 1991/12/1
N2 - 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.
AB - 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.
KW - Operative mortality
KW - Unstable angina
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M3 - Article
C2 - 1859662
AN - SCOPUS:0026066528
VL - 5
SP - 235
EP - 243
JO - European Journal of Cardio-thoracic Surgery
JF - European Journal of Cardio-thoracic Surgery
SN - 1010-7940
IS - 5
ER -