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Ischemic myocardial injury following aorto-coronary bypass surgery
Insights
Acute myocardial injury after aorto-coronary bypass surgery occurred in 9.9% of patients, with significant enzyme level changes observed. This study assessed myocardial infarction incidence and outcomes in bypass surgery patients.
Area of Science:
- Cardiology
- Cardiac Surgery
- Biochemistry
Background:
- Aorto-coronary bypass surgery is a common procedure.
- Assessing perioperative myocardial injury is crucial for patient outcomes.
Purpose of the Study:
- To determine the incidence of acute myocardial injury post-aorto-coronary bypass surgery.
- To evaluate the correlation between electrocardiogram (ECG) changes, cardiac enzyme levels, and surgical factors.
Main Methods:
- 151 patients undergoing bypass surgery were monitored.
- Serial ECGs and serum levels of SGOT, LDH, and CPK were analyzed pre- and post-operatively.
- Patients were categorized based on ECG findings: new myocardial infarction, ST-T changes, or no significant changes.
Main Results:
- 9.9% of patients (15/151) developed myocardial infarction (MI) based on Q wave criteria.
- 22.5% (33/151) showed significant ST-T changes on ECG.
- Postoperative SGOT levels were significantly higher in the MI group compared to the no-change group (P<0.01).
- No correlation was found between surgery type/site and MI incidence.
- The combined incidence of death (3.3%) and MI was 12.6%.
Conclusions:
- Acute myocardial injury, including MI, is a significant complication following bypass surgery.
- Elevated SGOT levels may indicate myocardial injury post-surgery.
- The overall risk of MI or death warrants consideration in this elective procedure.
Abstract:
To assess the incidence of acute myocardial injury following aorto-coronary bypass surgery 151 patients (136 men and 15 women) were evaluated by studying serial preoperative and postoperative ECGs and SGOT, LDH and CPK levels. The mean age of men was 49.1 and of women, 53.1 years. Following surgery 15 patients (group I, 9.9 percent) developed new myocardial infarction as judged by Q wave criteria, 33 patients (group II, 22.5 percent) developed significant ST-T changes, and 103 patients (group III, 68 percent) had no significant ECG change. Mean postoperative SGOT values were: group I,126.2; group II, 100.6; and group III, 72.8. Only the difference in SGOT values between group I and III was significant (P less than 0.01). There was no correlation between type and site of surgery and the incidence of myocardial infarction. There were five deaths (3.3 percent). The combination of death and diagnosed myocardial infarction amounted to 12.6 percent of patients for this widely used elective procedure.