Predictores clínicos de revascularización quirúrgica en pacientes cursando internación por síndromes coronarios agudos sin elevación del segmento ST - Registros Buenos Aires I y ReSCAR22

Julián M. Feder; Alan R. Sigal; Leonardo A. Seoane; Mirza Rivero; Gonzalo Perez; Ezequiel J. Zaidel; Fabricio G. Procopio; Diego Conde; Juan P. Costabel

doi:10.47487/apcyccv.v5i1.333

Authors

Julián M. Feder Instituto Cardiovascular de Buenos Aires, Buenos Aires, Argentina. https://orcid.org/0009-0003-0186-5348
Alan R. Sigal Instituto Cardiovascular de Buenos Aires, Buenos Aires, Argentina. https://orcid.org/0000-0002-2169-2101
Leonardo A. Seoane Instituto Cardiovascular de Buenos Aires, Buenos Aires, Argentina. https://orcid.org/0000-0002-2039-5199
Mirza Rivero CEMIC, Buenos Aires, Argentina. https://orcid.org/0009-0007-1668-7221
Gonzalo Perez Clínica Olivos, Buenos Aires, Argentina. https://orcid.org/0000-0002-2872-767X
Ezequiel J. Zaidel Sanatorio Güemes, Buenos Aires, Argentina. https://orcid.org/0000-0001-8349-7507
Fabricio G. Procopio Hospital Universitario Fundación Favaloro, Buenos Aires, Argentina. https://orcid.org/0009-0003-1017-7563
Diego Conde Instituto Cardiovascular de Buenos Aires, Buenos Aires, Argentina. https://orcid.org/0000-0001-6518-8823
Juan P. Costabel Instituto Cardiovascular de Buenos Aires, Buenos Aires, Argentina. https://orcid.org/0000-0003-0073-5739

DOI:

https://doi.org/10.47487/apcyccv.v5i1.333

Keywords:

Myocardial Revascularization, Coronary Artery Disease, Acute Coronary Syndrome, Argentina

Abstract

Objectives. To identify predictors of coronary artery bypass graft surgery (CABG) requirement as a revascularization method in in real-world non-ST-segment elevation acute coronary syndrome (NSTE-ACS) patients. Materials and methods. An individual pre-specified analysis of patients with NSTE-ACS was performed from two prospective Argentine registries between 2017 and 2022. We analyzed the difference in baseline characteristics between patients who required CABG and those who did not require this intervention. Then, a logistic regression analysis was performed to determine independent predictors in patients who received CABG as a method of revascularization. Results. A total of 1848 patients with a median age of 54.8 (interquartile range [IQR]: 53.7-56) years and an ejection fraction of 42.1% (IQR: 41.2-43.1) were included. A total of 233 patients required CABG (12.6%). Baseline characteristics between the two groups were similar, except in patients requiring CABG, who were younger (51.5 vs. 55.7 years; p=0.010), more frequently diabetic (38.2% vs. 25.7%; p=0.001) and male (90.1% vs. 73.7%; p=0.001). In addition, they had, to a lesser extent, previous cardiac surgery (2.1% vs. 11.2%; p=0.011). After multivariable analysis, the following were independently associated with CABG: age (Odds Ratio [OR]: 0.99, 95% confidence interval [CI]: 0.98-0.99; p=0.008), male sex (OR: 3.08, 95% CI: 1.87-5.1; p=0.001), history of previous CABG (OR: 0.14, 95% CI: 0.05-0.30; p=0.001) and diabetes (OR: 1.84, 95% CI: 1.31- 2.57; p=0.001). Conclusions. In this analysis of two NSTEACS registries, younger age, male sex, a diagnosis of diabetes and the absence of previous surgery were independent predictors of the requirement for inpatient CABG.

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