Predictors and outcomes of cardiac complications following elective coronary bypass grafting

Proc Assoc Am Physicians. 1999 Nov-Dec;111(6):622-32. doi: 10.1046/j.1525-1381.1999.99130.x.

Abstract

Our objective was to determine the predictors of cardiac complications among a cohort of elective coronary artery bypass graft (CABG) surgery patients and to determine the relationship of such complications to subsequent quality of life and symptoms. A total of 248 patients were enrolled and 237 completed 6 month follow-up. The combined rate of both major and minor cardiac complications was 9.7% (n = 24). Patients in this study were evaluated preoperatively, monitored intraoperatively, followed immediately postoperatively and at 6 months. Major cardiac complications accounted for 3.6% (n = 9) and minor complications for 6% (n = 15). Using multivariable logistic regression analysis, the predictors of major cardiac complications were receiving diuretics preoperatively (p = .01) and increased time during cross-clamping (p = .006). At 6 months after surgery, 19% of the patients with postoperative cardiac complications experienced worsening of symptoms, in contrast to only 8% of those without cardiac complications (p = .03). We concluded that patients who were on preoperative diuretics and those who had longer cross-clamp times were at higher risk of cardiac complications. The majority of patients who had acute cardiac complications had improved function and symptoms at 6 months postoperatively.

Publication types

  • Clinical Trial
  • Randomized Controlled Trial
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Aged
  • Cardiac Output, Low / epidemiology
  • Cardiac Output, Low / etiology
  • Cardiovascular Agents / therapeutic use
  • Cohort Studies
  • Comorbidity
  • Coronary Artery Bypass* / adverse effects
  • Diuretics / administration & dosage
  • Diuretics / adverse effects
  • Female
  • Follow-Up Studies
  • Heart Arrest, Induced / methods
  • Heart Diseases / epidemiology*
  • Heart Diseases / etiology
  • Hemodynamics / drug effects
  • Humans
  • Intraoperative Care
  • Intraoperative Period
  • Male
  • Middle Aged
  • Monitoring, Intraoperative
  • Myocardial Infarction / epidemiology
  • Myocardial Infarction / etiology
  • New York / epidemiology
  • Postoperative Complications / epidemiology*
  • Postoperative Complications / etiology
  • Preoperative Care
  • Prognosis
  • Prospective Studies
  • Pulmonary Edema / epidemiology
  • Pulmonary Edema / etiology
  • Respiratory Distress Syndrome / epidemiology
  • Respiratory Distress Syndrome / etiology
  • Severity of Illness Index
  • Single-Blind Method
  • Treatment Outcome

Substances

  • Cardiovascular Agents
  • Diuretics