[Coronary artery bypass graft surgery in patients with acute coronary syndrome. Analysis of results].

BACKGROUND: The objective of this work was to determine the main risk factors that influence prognosis, results, morbidity and mortality rates and causes in patients with acute coronary syndrome requiring surgical myocardial revascularization.

METHODS: This was a retrospective study including patients in our hospital with acute coronary syndrome requiring coronary artery bypass-graft surgery between January 2000 and December 2003. The following were identified and compared with international values: demographic factors, indications for surgery, intercurrent pathologies, results of the procedures, morbidity and mortality rates and causes.

RESULTS: There were 73 males and 23 females with an age range of 46 to 88 years old. The main cause of surgery was unstable angina (42.7%). In two patients, surgery was indicated for percutaneous coronary angioplasty failure and in 28 patients due to mechanical complications of acute myocardial infarction. The procedure was urgent in 90.6%. The majority of patients were in Killip-Kimball or Forrester class I or II. Risk factors detected were left ventricular failure, mechanical complications, emergency surgery, diabetes and respiratory or renal failure. Perioperative mortality was 14.5% and morbidity was 41.6%, both compared with risk classification scales and were lower than expected according to Parsonet and Tuman evaluations.

CONCLUSIONS: With a major number of risk factors and the high-risk associated with surgery, in our center surgical treatment for acute coronary syndromes showed favorable results.