[Surgical revascularization in patients with acute coronary syndromes: early outcome]

Between January 1 2001 and June 30 2002, 2204 CABG procedures were performed in our institution. 110 patients underwent urgency CABG within six hours of ACS. We analyzed their short-term results.

55 patients underwent CABG for UAP, 31 for STEMI and 24 for NSTEMI. In the control group, 55 patients underwent elective revascularization. Preoperative, intraoperative, and postoperative data were analyzed.

Hospital mortality was 12.9%, 8.3%, 7.3% and 1.9% for groups with STEMI, NSTEMI, UAP and stable angina, respectively. Independent predictors of early mortality, in order of decreasing importance, were: preoperative extracardiac arteriopathy (p = 0.0002), cardiac arrest befor CABG (p = 0.0003), preoperative shock (p = 0.003), STEMI (p = 0.03) and LVEF < 40% (p = 0.03).

CABG procedures should be a standard part of ACS treatment. Patients with UAP and NSTEMI can be safely operated during the early course of ACS. CABG can be performed with acceptable early-term risk in patients with STEMI and hemodynamic instability.