SciELO - Scientific Electronic Library Online

 
vol.80 issue2Socioeconomic aspects of spousal concordance for hypertension, obesity, and smoking in a community of Rio de Janeiro, BrazilRight ventricular diastolic dysfunction in the postoperative period of tetralogy of Fallot author indexsubject indexarticles search
Home Pagealphabetic serial listing  

Arquivos Brasileiros de Cardiologia

Print version ISSN 0066-782X

Abstract

ROCHA, Antônio Sérgio Cordeiro da  and  SILVA, Paulo Roberto Dutra da. Can patients with left main coronary artery disease wait for myocardial revascularization surgery?. Arq. Bras. Cardiol. [online]. 2003, vol.80, n.2, pp. 191-203. ISSN 0066-782X.  http://dx.doi.org/10.1590/S0066-782X2003000200007.

OBJECTIVE: To assess the occurrence of cardiac events in patients diagnosed with left main coronary artery disease on diagnostic cardiac catheterization and waiting for myocardial revascularization surgery. METHODS: All patients diagnosed with left main coronary artery disease (stenosis ³50%) consecutively identified on diagnostic cardiac catheterization during an 8-month period were selected for the study. The group comprised 56 patients (40 males and 16 females) with a mean age of 61±10 years. The cardiac events included death, nonfatal acute myocardial infarction, acute left ventricular failure, unstable angina, and emergency surgery. RESULTS: While waiting for surgery, patients experienced the following cardiac events: 7 acute myocardial infarctions and 1 death. All events occurred within the first 60 days after the diagnostic cardiac catheterization. More patients, whose indication for diagnostic cardiac catheterization was unstable angina, experienced events as compared with those with other indications [p=0.03, relative risk (RR) = 5.25, 95% confidence interval = 1.47 - 18.7]. In the multivariate analysis of logistic regression, unstable angina was also the only factor that independently contributed to a greater number of events (p = 0.02, OR = 8.43, 95% CI =1.37 - 51.7). CONCLUSION: Unstable angina in patients with left main coronary artery disease acts as a high risk factor for cardiac events, emergency surgery being recommended in these cases.

Keywords : left main coronary artery disease; surgical indication; cinecoronary arteriography.

        · text in English     · pdf in English