Cirurgia de revasculariza？？o miocárdica na fase aguda do infarto: análise dos fatores preditores de mortalidade intra-hospitalar

objective: coronary artery bypass grafting (cabg) during the acute phase of infarction (ami) is associated with increased operative risk. the aim of this study was to determine predictors of in-hospital mortality in patients undergoing cabg in ami. methods: during three years, all patients undergoing cabg in ami were retrospectively analyzed of the institutional database. sixty variables per patient were evaluated: 49 preoperative variables from the 2000 bernstein-parsonnet and euroscore models, 4 preoperative variables not considered in these models (time between ami and cabg, maximum ckmb, troponin maximum and st-segment elevation) and 7 intraoperative variables [(cardiopulmonary bypass (cpb), cpb time, type of cardioplegia, endarterectomy, number of grafts, use of internal thoracic artery and complete revascularization]. univariate and multivariate analysis for the outcome of in hospital mortality were performed. results: the mean time between ami and cabg was 3.8 ± 3 days. the overall mortality was 19%. in the multivariate analysis: age > 65 years or [16.5 (ci 1.8 to 152), p= 0.013]; cpb > 108 minutes [or 40 (ci 2.7 to 578), p= 0.007], creatinine> 2 mg/dl [or 35.5 (ci 1.7 to 740), p= 0.021] and systolic pulmonary pressure > 60 mmhg [or 31 (ci 1.6 to 591), p= 0.022] were predictors of in-hospital mortality. conclusion: conventional preoperative variables such as age > 65 years, creatinine > 2 mg/dl and systolic pulmonary pressure > 60 mmhg were predictive of inhospital mortality in patients underwent cabg in ami.