Risk factors for acute myocardial infarction during the postoperative period of myocardial revascularization.
OBJECTIVE
To identify risk factors for acute myocardial infarction during the postoperative period after myocardial revascularization.


METHODS
This was a case-control study paired for sex, age, number, type of graft used, coronary endarterectomy, type of myocardial protection, and use of extracorporeal circulation. We assessed 178 patients (89 patients in each group) undergoing myocardial revascularization, and the following variables were considered: dyslipidemia, systemic hypertension, smoking, diabetes mellitus, previous myocardial revascularization surgery, previous coronary angioplasty, and acute myocardial infarction.


RESULTS
Baseline clinical characteristics did not differ in the groups, except for previous myocardial revascularization surgery, prevalent in the case group (34 patients vs. 12 patients; p = 0.0002). This was the only independent predictor of risk for acute myocardial infarction in the postoperative period, based on a multivariate logistic regression analysis (p = 0.0001). Mortality and the time of hospital stay of the case group were significantly higher (19.1% vs. 1.1%; p < 0.001 and 15.7 days vs. 10.6 days; p < 0.05 respectively) than those of the control.


CONCLUSIONS
Only previous myocardial revascularization was an independent predictor of acute myocardial infarction in the postoperative period, based on multivariate logistic regression analysis.
Júnior Costa
José Ribamar
JR
Hospital do Coração-Rua Desembargador Eliseu Guilherme, 123-04004-030-São Paulo, SP, Brazil. rmvcosta@uol.com.br
Oliveira
Dinaldo C
DC
DerBedrossian
Alexei
A
Egito
Enilton T
ET
Romano
Edson R
ER
Barbosa
Marcos O
MO
Liguori
Ieda M
IM
Fahran
Jorge
J
Souza
Luis C
LC
Jatene
Adib D
AD
Piegas
Leopoldo S
LS
D001938:Brazil / Q000453:epidemiology; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D015994:Incidence; D007902:Length of Stay; D008297:Male; D015999:Multivariate Analysis; D009203:Myocardial Infarction / Q000209:etiology* / Q000401:mortality; D009204:Myocardial Revascularization / Q000401:mortality; D016017:Odds Ratio; D011183:Postoperative Complications; D012189:Retrospective Studies; D012307:Risk Factors