March 1985

Operative Risk Factors Associated With Unstable Angina Pectoris

Author Affiliations

From the Departments of Surgery (Drs Eugene, Ott, and Stemmer) and Medicine (Dr Piters), Veterans Administration (VA) Medical Center—Long Beach, Calif, and the University of California at Irvine.

Arch Surg. 1985;120(3):279-282. doi:10.1001/archsurg.1985.01390270019004

• We performed a prospective study in 207 patients with unstable angina pectoris (UA) to identify factors associated with operative mortality (OM) and perioperative myocardial infarction (Ml) from myocardial revascularization. The OM was 3.9% (8/207) and the incidence of Ml was 11% (23/207). Clinical variables (age, prior Ml, electrocardiographic evidence, symptoms, left ventricular function) and operative variables (incomplete revascularization, cardiopulmonary bypass time, cross-clamp time) did not correlate with OM or Ml. Operative mortality was associated with critical triple-vessel disease, but not left main coronary artery disease, and accounted for seven of the eight deaths (P<.01). Myocardial infarction was associated with elective surgery (22/167) as opposed to urgent surgery (1/40) (P<.01). Therefore, patients with critical triple-vessel disease are the highest risk group for OM, and urgent operation seems to reduce the incidence of Ml in patients with UA.

(Arch Surg 1985;120:279-282)