Epidemiological Characteristics and Mortality Predictors in Patients Over 70 Years Submitted to Coronary Artery Bypass Grafting

Kaufman, Renato; Azevedo, Vitor Manuel Pereira; Sá, Rodrigo Mazzarone Gomes de; Geller, Mauro; Xavier, Regina Maria de Aquino; Chaves, Rogério Brant Martins; Castier, Marcia Bueno

doi:10.5935/2359-4802.20180020

Renato Kaufman

Instituto Estadual de Cardiologia Aloysio de Castro, Rio de Janeiro, RJ - Brazil;

Vitor Manuel Pereira Azevedo

Instituto Nacional de Cardiologia, Rio de Janeiro, RJ - Brazil;

Rodrigo Mazzarone Gomes de Sá Mailing Address: Rodrigo Mazzarone Gomes de Sá. Praca Antonio Callado, 215/ 305. Postal Code: 22793-084, Barra da Tijuca, Rio de Janeiro, RJ - Brazil. E-mail: rmazzarone@gmail.com; rodgomesdesa@gmail.com

Instituto Estadual de Cardiologia Aloysio de Castro, Rio de Janeiro, RJ - Brazil;

Mauro Geller

Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ - Brazil;

Regina Maria de Aquino Xavier

Instituto Nacional de Cardiologia, Rio de Janeiro, RJ - Brazil;

Rogério Brant Martins Chaves

Instituto Nacional de Cardiologia, Rio de Janeiro, RJ - Brazil;

Marcia Bueno Castier

Universidade do Estado do Rio de Janeiro, Rio de Janeiro, RJ - Brazil

Mailing Address: Rodrigo Mazzarone Gomes de Sá. Praca Antonio Callado, 215/ 305. Postal Code: 22793-084, Barra da Tijuca, Rio de Janeiro, RJ - Brazil. E-mail: rmazzarone@gmail.com; rodgomesdesa@gmail.com

Author contributions

Conception and design of the research: Azevedo VMP, Xavier RMA, Chaves RBM. Acquisition of data: Azevedo VMP, Xavier RMA, Chaves RBM. Analysis and interpretation of the data: Kaufman R, Azevedo VMP, Sá RMG, Geller M, Xavier RMA, Chaves RBM, Castier MB. Statistical analysis: Kaufman R, Azevedo VMP, Geller M. Writing of the manuscript: Kaufman R, Azevedo VMP, Sá RMG, Xavier RMA, Chaves RBM, Castier MB. Critical revision of the manuscript for intellectual content: Kaufman R, Azevedo VMP, Castier MB.

Potential Conflict of Interest

No potential conflict of interest relevant to this article was reported.

Characteristic
Age, years (median and interquartile range)	74.26 (71.77-77.08)
Men	67.2
Body mass index	26.2 ± 4.1
Systemic arterial hypertension	93.2
Diabetes Mellitus	29.0
Smoking	4.3
Previous acute myocardial infarction	19.4
Previous stroke	5.3
Creatinine clearance	51.77 (42.38-61.86)
Creatinine	1.1 (1.0-1.38)
Previous coronary artery bypass grafting	2.1
Previous percutaneous coronary angioplasty	9.1
Angina	80.9
Unstable angina	27.6
Stable angina	72.4
Left main coronary artery lesion	41.9
Proximal anterior descending artery lesion	62.0
Trivascular	75.0
Ejection fraction	62.0 (49.0-69.0)
NYHA functional class III or IV	9.2
Death at 30 days	19.3

Variable	Death (%)	Survivor (%)	p-value
Combined surgery	40.00	15.82	< 0.001
NYHA Functional class III or IV	38.24	17.26	0.003
Emergency surgery	40.91	18.00	0.004
Use of statins in the preoperative period	16.84	30.43	0.017
Peripheral vascular disease	30.16	17.12	0.018
Previous surgery	31.37	17.35	0.019
Moderate/severe tricuspid regurgitation	60.00	18.44	0.019
Moderate/severe aortic regurgitation	38.89	18.07	0.029
Moderate/severe mitral regurgitation	34.78	17.93	0.040
Moderate/severe aortic stenosis	32.81	16.03	0.002
Nitrates in the preoperative period	33.33	17.99	0.051
Beta-blocker in the preoperative period	32.81	28.57	0.056
Male gender	17.60	22.95	0.220
Diabetes	15.74	20.91	0.253
Left main coronary artery lesion	18.59	19.52	0.822

Variable	Survivor	Death	p-value
Left atrial dimension, cm	3.91 (3.84-3.98)	4.13 (3.94-4.32)	0.0129
Body mass index, kg/m²	26.11 (25.72-26.50)	26.80 (25.36-28.24)	0.3162
Age, years	74.15 (71.73-7.08)	74.81 (72.16-77.23)	0.3505
Left ventricular ejection fraction, %	58.77 (57.12-60.43)	55.76 (51.62-59.90)	0.7250
Pulmonary artery systolic pressure, mmHg	35.50 (32.11-38.89)	39.83 (33.97-45.68)	0.9114

Factor	Odds ratio	Standard error	95%CI	p-value
Emergency surgery	4.4952	2.5857	1.4559-13.879	0.009
Peripheral vascular disease	2.5038	0.9111	1.2271-5.1091	0.012
Left atrial dimension	1.4488	0.3623	0.8874-2.3655	0.138
Combined surgery	2.1760	1.2039	0.7357-6.4358	0.160
Previous surgery	1.6740	0.6984	0.7390-3.7925	0.217
Moderate/severe tricuspid regurgitation	3.1501	3.1348	0.4479-22.152	0.249
Beta-blocker in the preoperative period	0.6536	0.2706	0.2903-1.4715	0.304
Moderate/severe aortic stenosis	1.4779	0.7335	0.5587-3.9096	0.431
Statins in the preoperative period	0.8023	0.3059	0.3800-1.6941	0.564
NYHA III-IV	1.3249	0.6894	0.4777-3.6742	0.589
Nitrates in the preoperative period	1.2760	0.8513	0.3451-4.7179	0.715
Moderate/severe aortic regurgitation	0.9405	0.5882	0.2761-3.2041	0.922

Factor	Odds ratio	Standard error	95%CI	p-value
Combined surgery	3.8651	1.2871	2.0123-7.4236	< 0.001
Emergency surgery	4.8608	2.3881	1.8558-12.732	0.001
Peripheral vascular disease	2.4773	0.8218	1.2931-4.7463	0.006

[1] Mailing Address: Rodrigo Mazzarone Gomes de Sá. Praca Antonio Callado, 215/ 305. Postal Code: 22793-084, Barra da Tijuca, Rio de Janeiro, RJ - Brazil. E-mail: rmazzarone@gmail.com; rodgomesdesa@gmail.com

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Epidemiological Characteristics and Mortality Predictors in Patients Over 70 Years Submitted to Coronary Artery Bypass Grafting