Age as a Prognostic Factor in Patients with Acute Coronary Syndrome undergoing Urgent/Emergency Cardiac Surgery - 07/09/15
, Chiara Lazzeri, MD, Pierluigi Stefàno, MD, Marco Chiostri, MD, Claudio Blanzola, MD, Alessandra Rossi, MD, Giuseppe Olivo, MD, Stefano Del Pace, MD, Gian Franco Gensini, MD, Serafina Valente, MDRésumé |
Background |
Patients presenting with acute coronary syndrome (ACS) who require urgent/emergency coronary artery bypass grafting (CABG) are increasing, as is the complexity of their clinical characteristics, one of which is advanced age. We evaluated the prognostic role of age in patients undergoing urgent/emergency cardiac surgery for ACS.
Methods |
From January to December 2013, 452 consecutive patients underwent CABG at our institution. Among these, 213 presented with ACS, were enrolled in the study and divided into tertiles of age: First: 40-65 years old (n=73), Second: 66-74 (n=70), Third: 75-89 (n=70). Patients were followed post-operatively for 30 days.
Results |
No differences between tertiles were found for baseline clinical and angiographic characteristics. Off-pump interventions were 67.6%. Older patients more frequently required an associate intervention to CABG for a mechanical complication of ACS. Overall 30-day all-cause mortality was 4.7% (n=10); 0.6% (n=1) in patients undergoing isolated CABG (n=168, 78.9%). The STEMI diagnosis was an independent risk factor for 30-day mortality, and age was not.
Conclusions |
The 30-day mortality rate of older ACS patients who undergo urgent/emergency CABG is comparable to that of younger ones. Pre-operative risk assessment should rely on evaluation of the clinical complexity of each patient independent of their chronological age, to customise the therapeutic strategy.
Le texte complet de cet article est disponible en PDF.Keywords : Acute coronary syndrome, Urgent coronary artery bypass grafting, Emergency revascularisation, Age, Prognostic factor, Elderly patient
Plan
Vol 24 - N° 9
P. 845-853 - septembre 2015 Retour au numéro
Article précédent
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