title: [Myocardial infarction after coronary bypass surgery. Associated factors and prognosis].
abstract: This paper studies the factors associated with perioperative myocardial infarction after coronary bypass surgery and assesses the medium-term prognosis of these patients. Four hundred and seventy patients underwent coronary bypass surgery between January 1983 and December 1986. The appearance and persistence of pathological Q waves, absent on the preoperative ECG, was the unique criterion of perioperative infarction. This complication was observed in 36 patients (7.65%). A comparison of these patients with a random group of 144 of teh 434 patients without perioperative infarction showed that they had a higher incidence of crescendo angina (55% vs 21%; p less than 0.001), ST-T wave changes on the resting ECG (78% vs 46%; p less than 0.001) and poor distal left anterior descending network (33% vs 13%; p less than 0.001): in addition, the group with infarction had a lower left ventricular ejection fraction (0.58 vs 0.64, p less than 0.01), incomplete myocardial revascularisation procedures (58% vs 32%; p less than 0.01), longer cardiopulmonary bypass times (86 mn vs 69 mn; p less than 0.001) and longer aortic clamping times (44.5 mn vs 37.4 mn p less than 0.05). The acute phase of the perioperative infarct was characterised by a higher incidence of major cardiac complications such as low output states (30.5% vs 2.02%; p less than 0.001). The hospital mortality was higher in the infarct group (8.3% vs 2.01%) but this was not statistically significant. After an average follow-up of 44 +/- 3 months, the 5 year survival rate was 95.4 +/- 2.1 per cent in patients without infarction and 76.5 +/- 6.9 per cent in those with perioperative infarction (p less than 0.001).(ABSTRACT TRUNCATED AT 250 WORDS)
authors.affiliation: Service de cardiologie, hôpital cardiovasculaire Louis-Pradel, Lyon.
authors.forename: A
authors.initials: A
authors.lastname: Dubost
authors.forename: G
authors.initials: G
authors.lastname: De Gevigney
authors.forename: C
authors.initials: C
authors.lastname: Zambartas
authors.forename: H
authors.initials: H
authors.lastname: Milon
authors.forename: J P
authors.initials: JP
authors.lastname: Delahaye
mesh_terms: D000206:Actuarial Analysis; D000368:Aged; D000790:Angiocardiography; D001026:Coronary Artery Bypass / Q000009:adverse effects* / Q000401:mortality; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000453:epidemiology / Q000209:etiology* / Q000401:mortality; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors
vernacular_title: L'infarctus du myocarde post-pontage. Facteurs associés et pronostic.