title: Recurrent ischemic heart disease: the effect of advancing age.
abstract: Four thousand four hundred and thirty open heart operations were performed at Mercy Hospital of Pittsburgh from January 1, 1988, to June 30, 1992. During that period, 168 patients were evaluated for recurrent ischemic heart disease after prior coronary artery revascularization. Forty-four were treated non operatively, the mode of therapy being transluminal angioplasty or medical management. The remaining 124 patients underwent repeat coronary revascularization. An attempt was made to define the impact of advancing age on the magnitude of risk factors, morbidity, and mortality. Advancing age is not a contraindication to repeat coronary artery revascularization. The average interval between the initial operation and the need for repeat revascularization is eight years. Younger patients have progression of their coronary artery disease, but progression of the arteriosclerotic process is in their extracranial cerebral arteries, renal arteries, and aortic segments as well as the coronary arteries. The utilization of tobacco, recent myocardial infarction, diabetes mellitus, and elevation of cholesterol are strong indicators for recurrent disease and add to the risk of repeat surgical intervention.
authors.affiliation: Department of Cardiovascular Surgery, Mercy Hospital of Pittsburgh, Pennsylvania 15219-5166.
authors.forename: R V
authors.initials: RV
authors.lastname: Pellegrini
authors.forename: R F
authors.initials: RF
authors.lastname: Di Marco
authors.forename: A M
authors.initials: AM
authors.lastname: Werner
authors.forename: A G
authors.initials: AG
authors.lastname: Marrangoni
mesh_terms: D017677:Age Distribution; D000368:Aged; D000375:Aging; D015906:Angioplasty, Balloon, Coronary / Q000706:statistics & numerical data; D000075202:Contraindications; D001026:Coronary Artery Bypass / Q000379:methods / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D017202:Myocardial Ischemia / Q000453:epidemiology* / Q000628:therapy; D010414:Pennsylvania / Q000453:epidemiology; D011183:Postoperative Complications / Q000453:epidemiology; D012008:Recurrence; D012086:Reoperation / Q000706:statistics & numerical data; D012307:Risk Factors; D013997:Time Factors