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Article |

Operative Risk Factors Associated With Unstable Angina Pectoris

John Eugene, MD; Richard A. Ott, MD; Kenneth M. Piters, MD; Edward A. Stemmer, MD
Arch Surg. 1985;120(3):279-282. doi:10.1001/archsurg.1985.01390270019004.
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• 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)


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