Document Detail

Risk factors for fatal myocardial infarction after coronary bypass graft surgery.
MedLine Citation:
PMID:  11350475     Owner:  NLM     Status:  MEDLINE    
BACKGROUND AND OBJECTIVE: The incidence and clinical impact of perioperative myocardial infarction during coronary artery bypass graft surgery vary greatly depending upon the diagnostic criteria applied. Fatal perioperative myocardial infarction has a less arguable diagnosis and clinical impact. The aim of this paper is to find out the risk factors for fatal myocardial infarction after coronary surgery.
METHODS: Data from 1561 consecutive patients, who underwent coronary revascularization during a 10-month period, have been retrospectively analysed. After an univariate analysis for pre- and intraoperative risk factors, a multivariate model (logistic regression analysis) was settled.
RESULTS: Preoperative use of subcutaneous/intravenous heparin, a heparin sensitivity index < 1.3 and need for a thromboendarterectomy of the left anterior descending coronary artery are independent risk factors for fatal myocardial infarction. The relative risk for fatal myocardial infarction was about 2 in the case of preoperative heparin use or heparin sensitivity index < 1.3 and 5.5 in the case of thromboendarterectomy of the left anterior descending coronary artery.
CONCLUSIONS: In patients undergoing coronary artery bypass surgery, preoperative anticoagulation management with heparin may represent a risk factor for fatal myocardial infarction. Patterns of heparin resistance, whether or not due to heparin pretreatment, seem to be closely related to fatal myocardial infarction.
M Ranucci; A Frigiola; L Menicanti; A Cazzaniga; G Soro; G Isgrò
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  European journal of anaesthesiology     Volume:  18     ISSN:  0265-0215     ISO Abbreviation:  Eur J Anaesthesiol     Publication Date:  2001 May 
Date Detail:
Created Date:  2001-05-14     Completed Date:  2001-07-05     Revised Date:  2011-01-11    
Medline Journal Info:
Nlm Unique ID:  8411711     Medline TA:  Eur J Anaesthesiol     Country:  England    
Other Details:
Languages:  eng     Pagination:  322-9     Citation Subset:  IM    
Departments of Cardiovascular Anesthesia and Cardiac Surgery, Cardiovascular Center E. Malan, University of Milan, San Donato Hospital, Milan, Italy.
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MeSH Terms
Coronary Artery Bypass / mortality*
Endpoint Determination
Logistic Models
Middle Aged
Multivariate Analysis
Myocardial Infarction / mortality*
Postoperative Complications / mortality*
Retrospective Studies
Risk Factors

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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