Original Articles • Int. J. Cardiovasc. Sci. 31
(3)
• May-Jun 2018 • https://doi.org/10.5935/2359-4802.20180020 linkcopy
Epidemiological Characteristics and Mortality Predictors in Patients Over 70 Years Submitted to Coronary Artery Bypass Grafting
Authorship
person Renato Kaufman
person Vitor Manuel Pereira Azevedo
person Mauro Geller
person Regina Maria de Aquino Xavier
person Rogério Brant Martins Chaves
person Marcia Bueno Castier
Mailing Address: Rodrigo Mazzarone Gomes de Sá. Praca Antonio Callado, 215/ 305. Postal Code: 22793-084, Barra da Tijuca, Rio de Janeiro, RJ - Brazil. E-mail:
rmazzarone@gmail.com;
rodgomesdesa@gmail.com
rmazzarone@gmail.com;
rodgomesdesa@gmail.com
Author contributions
Conception and design of the research: Azevedo VMP, Xavier RMA, Chaves RBM. Acquisition of data: Azevedo VMP, Xavier RMA, Chaves RBM. Analysis and interpretation of the data: Kaufman R, Azevedo VMP, Sá RMG, Geller M, Xavier RMA, Chaves RBM, Castier MB. Statistical analysis: Kaufman R, Azevedo VMP, Geller M. Writing of the manuscript: Kaufman R, Azevedo VMP, Sá RMG, Xavier RMA, Chaves RBM, Castier MB. Critical revision of the manuscript for intellectual content: Kaufman R, Azevedo VMP, Castier MB.
Potential Conflict of Interest
No potential conflict of interest relevant to this article was reported.
SCIMAGO INSTITUTIONS RANKINGS
Instituto Estadual de Cardiologia Aloysio de Castro, Rio de Janeiro, RJ - Brazil;Instituto Estadual de Cardiologia Aloysio de CastroBrazilRio de Janeiro, RJ, BrazilInstituto Estadual de Cardiologia Aloysio de Castro, Rio de Janeiro, RJ - Brazil;
Instituto Nacional de Cardiologia, Rio de Janeiro, RJ - Brazil;Instituto Nacional de CardiologiaBrazilRio de Janeiro, RJ, BrazilInstituto Nacional de Cardiologia, Rio de Janeiro, RJ - Brazil;
Tables
table_chartTable 1
Demographic and clinical characteristics of the study population
| Characteristic | |
|---|---|
| Age, years (median and interquartile range) | 74.26 (71.77-77.08) |
| Men | 67.2 |
| Body mass index | 26.2 ± 4.1 |
| Systemic arterial hypertension | 93.2 |
| Diabetes Mellitus | 29.0 |
| Smoking | 4.3 |
| Previous acute myocardial infarction | 19.4 |
| Previous stroke | 5.3 |
| Creatinine clearance | 51.77 (42.38-61.86) |
| Creatinine | 1.1 (1.0-1.38) |
| Previous coronary artery bypass grafting | 2.1 |
| Previous percutaneous coronary angioplasty | 9.1 |
| Angina | 80.9 |
| Unstable angina | 27.6 |
| Stable angina | 72.4 |
| Left main coronary artery lesion | 41.9 |
| Proximal anterior descending artery lesion | 62.0 |
| Trivascular | 75.0 |
| Ejection fraction | 62.0 (49.0-69.0) |
| NYHA functional class III or IV | 9.2 |
| Death at 30 days | 19.3 |
-
Results expressed in median (interquartile range), percentage or mean ± median. NYHA: New York Heart Association.
table_chartTable 2
Univariate analysis of surgical mortality by the presence of categorical variables potentially predictive of surgical death
| Variable | Death (%) | Survivor (%) | p-value |
|---|---|---|---|
| Combined surgery | 40.00 | 15.82 | < 0.001 |
| NYHA Functional class III or IV | 38.24 | 17.26 | 0.003 |
| Emergency surgery | 40.91 | 18.00 | 0.004 |
| Use of statins in the preoperative period | 16.84 | 30.43 | 0.017 |
| Peripheral vascular disease | 30.16 | 17.12 | 0.018 |
| Previous surgery | 31.37 | 17.35 | 0.019 |
| Moderate/severe tricuspid regurgitation | 60.00 | 18.44 | 0.019 |
| Moderate/severe aortic regurgitation | 38.89 | 18.07 | 0.029 |
| Moderate/severe mitral regurgitation | 34.78 | 17.93 | 0.040 |
| Moderate/severe aortic stenosis | 32.81 | 16.03 | 0.002 |
| Nitrates in the preoperative period | 33.33 | 17.99 | 0.051 |
| Beta-blocker in the preoperative period | 32.81 | 28.57 | 0.056 |
| Male gender | 17.60 | 22.95 | 0.220 |
| Diabetes | 15.74 | 20.91 | 0.253 |
| Left main coronary artery lesion | 18.59 | 19.52 | 0.822 |
-
NYHA: New York Heart Association.
table_chartTable 3
Univariate analysis of surgical mortality by the presence of continuous variables potentially predictive of surgical death
| Variable | Survivor | Death | p-value |
|---|---|---|---|
| Left atrial dimension, cm | 3.91 (3.84-3.98) | 4.13 (3.94-4.32) | 0.0129 |
| Body mass index, kg/m2 | 26.11 (25.72-26.50) | 26.80 (25.36-28.24) | 0.3162 |
| Age, years | 74.15 (71.73-7.08) | 74.81 (72.16-77.23) | 0.3505 |
| Left ventricular ejection fraction, % | 58.77 (57.12-60.43) | 55.76 (51.62-59.90) | 0.7250 |
| Pulmonary artery systolic pressure, mmHg | 35.50 (32.11-38.89) | 39.83 (33.97-45.68) | 0.9114 |
table_chartTable 4
Multivariate analysis of surgical death predictors in the initial stage
| Factor | Odds ratio | Standard error | 95%CI | p-value |
|---|---|---|---|---|
| Emergency surgery | 4.4952 | 2.5857 | 1.4559-13.879 | 0.009 |
| Peripheral vascular disease | 2.5038 | 0.9111 | 1.2271-5.1091 | 0.012 |
| Left atrial dimension | 1.4488 | 0.3623 | 0.8874-2.3655 | 0.138 |
| Combined surgery | 2.1760 | 1.2039 | 0.7357-6.4358 | 0.160 |
| Previous surgery | 1.6740 | 0.6984 | 0.7390-3.7925 | 0.217 |
| Moderate/severe tricuspid regurgitation | 3.1501 | 3.1348 | 0.4479-22.152 | 0.249 |
| Beta-blocker in the preoperative period | 0.6536 | 0.2706 | 0.2903-1.4715 | 0.304 |
| Moderate/severe aortic stenosis | 1.4779 | 0.7335 | 0.5587-3.9096 | 0.431 |
| Statins in the preoperative period | 0.8023 | 0.3059 | 0.3800-1.6941 | 0.564 |
| NYHA III-IV | 1.3249 | 0.6894 | 0.4777-3.6742 | 0.589 |
| Nitrates in the preoperative period | 1.2760 | 0.8513 | 0.3451-4.7179 | 0.715 |
| Moderate/severe aortic regurgitation | 0.9405 | 0.5882 | 0.2761-3.2041 | 0.922 |
-
95% CI: 95% confidence interval; NYHA: New York Heart Association.
table_chartTable 5
Multivariate analysis of the factors predicting surgical death in the final stage
| Factor | Odds ratio | Standard error | 95%CI | p-value |
|---|---|---|---|---|
| Combined surgery | 3.8651 | 1.2871 | 2.0123-7.4236 | < 0.001 |
| Emergency surgery | 4.8608 | 2.3881 | 1.8558-12.732 | 0.001 |
| Peripheral vascular disease | 2.4773 | 0.8218 | 1.2931-4.7463 | 0.006 |
-
95% CI: 95% confidence interval.
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