Current incidence and determinants of perioperative myocardial infarction in coronary artery surgery

Sally C. Greaves, John D. Rutherford, Sary F. Aranki, Lawrence H. Cohn, Greg S. Couper, David H. Adams, Robert J. Rizzo, John J. Collins, Elliott M. Antman

Research output: Contribution to journalArticlepeer-review

56 Scopus citations

Abstract

Increasingly, patients undergoing coronary artery bypass grafting (CABG) are elders, have had previous CABG, and have poor left ventricular function. To evaluate determinants of perioperative myocardial infarction (PMI) after isolated CABG, 499 consecutive patients were reviewed. Definite PMI (total peak creatine kinase [CK] >700 U/L, creatine kinase MB [CK-MB] >30 ng/ml, and new pathologic electrocardiographic Q waves) occurred in 25 patients (5.0%) and probable PMI (total peak CK >700 U/L, CK-MB >30 ng/ml, and a new wall- motion abnormality) occurred in 10 (2.0%) patients. According to multivariate logistic regression analysis, independent risk factors for definite or probable PMI (odds ratios; 95% confidence intervals) were emergency surgery (3.1; 1.1 to 8.4; p = 0.003), aortic cross-clamp time >100 minutes (4.2; 1.6 to 11.2; p = 0.004), myocardial infarction in the preceding week (2.6; 1.0 to 6.4; p = 0.04), and previous revascularization (2.4; 1.1 to 5.2; p = 0.02). In conclusion, both preoperative and intraoperative factors influence the risk of PMI after CABG. Despite changes in the profile of patients undergoing CABG, the incidence of PMI in this tertiary center is comparable with that found in earlier series, probably because of improvements in surgical techniques and postoperative care.

Original languageEnglish (US)
Pages (from-to)572-578
Number of pages7
JournalAmerican Heart Journal
Volume132
Issue number3
DOIs
StatePublished - Jan 1 1996

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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