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Unstable angina does not increase mortality in coronary artery bypass graft surgery

Carolina Pelzer Sussenbach, João Carlos Guaragna, Rômulo Soares Castagnino

    Revista Brasileira De Cirurgia Cardiovascular : Orgao Oficial Da Sociedade Brasileira De Cirurgia Cardiovascular
    |December 18, 2013
    PubMed

    Insights

    Coronary artery bypass grafting for unstable angina patients did not increase mortality. While these patients required more medications and monitoring, their outcomes showed a lower death rate post-procedure.

    Area of Science:

    • Cardiology
    • Cardiac Surgery
    • Clinical Outcomes Research

    Background:

    • Coronary artery bypass graft (CABG) is a primary treatment for unstable angina.
    • The impact of unstable angina on CABG morbidity remains unclear.

    Purpose of the Study:

    • To compare outcomes of CABG in patients with and without unstable angina.
    • To assess the influence of unstable angina on perioperative outcomes and mortality.

    Main Methods:

    • Retrospective cohort study design.
    • Unstable angina defined as acute coronary syndrome without ST elevation, enzymatic alteration, or class IV angina.
    • Analysis of 2,818 isolated CABG procedures between February 1996 and July 2010.

    Main Results:

    • 36.1% of patients had preoperative unstable angina.
    • Unstable angina patients used more medications (aspirin, beta-blockers, heparin, nitrates) and fewer diuretics.
    • Increased monitoring (Swan-Ganz) and intra-aortic balloon support were noted in unstable angina patients.
    • Unstable angina was associated with longer hospitalization (P=0.030) but a lower mortality rate (P=0.018).

    Conclusions:

    • Undergoing CABG with unstable angina does not elevate mortality rates.
    • Unstable angina patients exhibit different medication and support needs but do not face increased perioperative death.
    Abstract

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