Perfil clínico e mortalidade dos pacientes com IAMCSST submetidos à cirurgia de revascularização do miocárdio: registro VICTIM

• Autor(a) principal: Cardoso, Isabella Maria da Silva
• Data de Publicação: 2017
• Tipo de documento: Trabalho de conclusão de curso
• Idioma: por
• Título da fonte: Repositório Institucional da UFS
• Texto Completo: http://ri.ufs.br/jspui/handle/riufs/7504
• topic: Medicina; Saúde; Infarto do miocárdio; Revascularização do miocárdio; Medicine; Myocardial infarction; Revascularization of the myocardium; CIENCIAS DA SAUDE::MEDICINA

Background: Currently, myocardial revascularization surgery has a limited role in the treatment of Acute Coronary Syndrome because of the diversity of treatment options, especially in the case of patients with acute ST-segment elevation myocardial infarction (STEMI). This fact provided a change in the profile of the patient undergoing coronary artery bypass grafting (CABG). In Brazil, there is still a great lack of information about the particularities associated with the patients diagnosed with STEMI who underwent CABG. Objective: To describe the clinical, demographic and mortality characteristcs of patients diagnosed with acute myocardial infarction, attended at the hospitals with capable to perform primary angioplasty and who were submitted to CABG in Sergipe. Methods: This is a descriptive study, where the VICTIM study database was used. From a total of 707 patients, 36 patients with STEMI underwent CABG. The database for the period between December 2014 and March 2017 was analyzed in four hospitals with the capacity to perform primary angioplasty in Sergipe. After the first phase of data collection, an active search was performed on medical records and surgical reports of patients submitted to CABG. Results: The mean age was 59 (±10) years, the majority of the patients were men (75%), of non-white ethnicity (61,11%), belonging to social class E (41,67%) and who studied until elementary school (52,78%). Regarding the characteristics of the CABG, patients with at least 3 coronary arteries affected by critical lesions predominated (63,89%). The majority (47.22%) of the surgeries were performed within 15 to 30 days after the diagnosis of STEMI, and 61.11% of them were made to complete revascularization. The cardiopulmonary bypass was used in 94.44% of the CABG, and the mean length of stay in CPB was 112.72 (± 42.98) minutes. Mortality at 30 days post-CABG was 13.39%. Conclusion: In this contemporary record of 707 patients with STEMI, only 5% of patients undergoing CABG. Most of these patients underwent surgery within 15 to 30 days of STEMI. The mortality rate at 30 days after CABG for patients in this setting was elevated. Our data suggest that new studies should be carried out to investigate the potential reasons for the high mortality shown.