Early outcome after CABG in patients with acute coronary syndromes
CABG ; acute coronary syndrome
Objective. Between January 1 2001 and June 30 2002, 2204 CABG procedures were performed in our institution. 11 O patients underwent emergency CABG within first 6 hours of Acute Coronary Syndrome. Short-term results were analysed. Methods. 55 patients underwent CABG for Unstable Angina Pectoris (UAP), 31 for ST Elevation Myocardial Infarction (STEMI) and 24 for Non ST Elevation Myocardial Infarction (NSTEMI). In the control group, 55 patients underwent elective surgical revascularization. Preoperative, intraoperative, and postoperative data were analysed. Results. Hospital mortality was 12,9 %, 8,3 %, 7,3 % and 1,8 % for group with STEMI, NSTEMI, UAP and stable angina, respectively. Independent predictors of early mortality, in order of decreasing importance, included extracardiac arteriopathy (p=0,000) preoperative cardiac massage (p=0,0003), preoperative shock (p=0,003), STEMI (p=0,03) and Left Ventricular Ejection Fraction below 40% (p=0,03). Conclusions. CABG procedures should be standard part of ACS treatment. Patient with UAP and NSTEMI can be safely operated on early in the course of ACS. CABG can be performed with acceptable early-term risk in patients with STEMI and hemodynamic instability who are not candidates for PCI.