2015, Number 2
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ABSTRACTIntroduction: perioperative myocardial infarction is a complication with great impact in morbidity and mortality in cardiovascular anesthesia.
Objetive: Determine the posible risk factors associated to perioperative myocardial infarction in off-pump coronary artery bypass.
Methods: descriptive and cross-sectional study between September 2011-November 2012, in patients to whom myocardial revascularization without pump. The Odds Ratio value and confidence intervals of 95 % in patients with values of p ‹ 0.05 were considered to have a significant stadistical correlation.
Results: this study included 210 patients (75.2% men), mean age 62.3 ± 8.7 years, from these 30 with perioperative myocardial infartion. Patients with advanced age (OR 14.5; IC 95 %: 5.9-35.1), functional class IV of NYHA (OR 3.2; IC 95 %: 1.2-9.3), chronic renal failure (OR 6.8; IC 95 %: 1.6-28.7), pulmonary obstructive chronic disease (OR 4.5; IC 95 %: 1.9-10.4), diabetes mellitus tipe 1 (OR 7.1; IC 95 %: 3.1-16.3), tobacco addiction (OR 6.3; IC 95 %: 2.7-14.2), recent myocardial infarction (OR 6.6; IC 95 %: 1.3-34.2), FeVI ≤ 40% (OR 2.5; IC 95%: 1.1-5.7), unstable angina (OR 2.5; IC 95%: 1.1-6.2), heart failure (OR 27.5; IC 95%: 2.9-256.1) and coronary complex disease (OR 12.6; IC 95%: 5.2-30.7) showed a significant association with the presence of perioperative myocardial infarction. Patients without β blocker have 3 times as much of suffer myocardial infarction. Complications were significantly greater in these group, with a mortality of 23%.
Conclusions: the coexistents diseases that showed association with the presence of perioperative myocardial infarction, with a significant increase in them complications and mortality.
Agüero MO, Cruz BR, Cabrera PA, Suárez LJ, Pérez M. Procedimiento quirúrgico de revascularización miocárdica sin circulación extra-corpórea: Antecedentes. Cuidados anestésicos. Rev Cubana Anest Reanim. 2008;7(2). En línea. Consultado 14/10/2012. Disponible en: http://bvs.sld.cu/revistas/scar/indice.htm/