The present study demonstrates that in a surgical population of patients undergoing CABG, the existence of preoperative NSTE-ACS is associated with a significantly higher mortality within 30 days and a higher incidence of major adverse cardiac events, such as PMI or LCOS, depending on the degree of preoperative cTnI serum elevation. Furthermore, a pre-CABG cTnI level could be shown to be used as an incremental prognostic variable in this patient cohort. cTnI serum levels were…
From January 2001 to September 2004, preoperative cTnI was measured in 1,978 consecutive patients scheduled for isolated CABG. Preoperative cTnI values were available in 1,978 of 3,124 patients who fulfilled the inclusion criteria and in whom primary isolated CABG had been performed. Among these patients, negative preoperative cTnI levels ( 1.5 ng/mL) [Fig 1]. There were no significant differences between most perioperative patient characteristics of the remaining 1,146 CABG patients, who were initially not enrolled…
Clinical End Points The primary end point of the study was in-hospital mortality, defined as death from any cause within 30 days after surgery or during the same time period of hospitalization as well as postoperative MACE during the period of hospitalization including perioperative MI (PMI) and low cardiac output syndrome (LCOS). Secondary study end points were other postoperative complications such as stroke, new-onset ventricular arrhythmia , major bleeding, necessity for rethoracotomy, and postoperative renal failure requiring…
Risk stratification and outcomes research is an emerging issue in cardiovascular surgery and particularly in coronary artery bypass grafting (CABG) to predict morbidity and mortality as a measure of health-care performance. Although most risk scores give consistent predictions, the extent of acute preoperative myocardial injury in unstable coronary artery disease (CAD) ranging from microinfarctions due to preexisting microembolizing unstable plaques up to non-ST elevation acute coronary syndrome (NSTE-ACS) and ST-segment elevation myocardial infarction (STEMI) have…
