Sex Differences in Mortality After CABG Surgery

ABSTRACT INTRODUCTION: Numerous studies have shown that women undergoing coronary artery bypass graft surgery present higher mortality rate during hospitalization, and often complications when compared to men. OBJECTIVE: To compare the mortality of men and women undergoing coronary artery bypass graft surgery and identify factors related to differences occasionally found. METHODS: Retrospective cohort study conducted with 215 consecutive patients who underwent coronary bypass surgery. RESULTS: Women had a higher average age. Low body surface and dyslipidemia were more prevalent in women (1.65 vs . 1.85, P<0.001: 53% vs . 30%, P =0.001), whereas history of smoking and previous myocardial infarction were more prevalent in men (35% vs .14.7%, P =0.001; 20% vs . 2.7%, P =0.007). Regarding complications in the postoperative period, there was a higher rate of blood transfusions in women. The overall mortality rate was 5.6%, however there was no statistically significant difference in mortality between men and women. It was observed that among the patients who died, the average body surface area was lower than that of patients who did not have this complication. CONCLUSION: There was no difference in mortality between the sexes after coronary artery bypass graft in this service.

Impact of Cardiovascular Interventions on the Quality of Life in the Elderly

ABSTRACT INTRODUCTION: The elderly population is growing rapidly. Political and socio-economic changes led to the demographic transition in this population with the highest number of surgeries and as well as many comorbidities. OBJECTIVE: To evaluate the impact of cardiovascular intervention on quality of life of elderly patients after three and six months. METHODS: Analytical prospective cohort study with elderly between 60 and 80 years of age, of both sexes, with a diagnosis of coronary artery disease and underwent cardiovascular intervention during the period June 2010 to June 2011. Data were collected by individual interviews in the pre and postoperative periods (after three and six months) by telephone. We used the SF-36 to analyse quality of life in order to assess the physical and mental health of the study population. RESULTS: Of the 44 individuals evaluated, 59.1% were men, 75% in the range of 65 to 74 years, 38.6% were white and 38.6% were black, 31.8% were uneducated, 43.2% were married and 68.2% had less than a minimum wage. Prevailed patients: non-diabetics (68.2%), non-obese (81.8%), hypertensive (84.1%), non-alcoholic and non-smokers (68.2% and 61.4%, respectively). A significant increase in the average of the SF-36 scores between pre and post-surgical periods (three and six months) for the domains: functional capacity, pain, general health, vitality and emotional aspect. CONCLUSION: The elderly population undergoing intervention may have cardiovascular benefits and improvements of quality of life. Physical fitness improvement measures can be taken to resume that capability.

Depression after CABG: a prospective study / Depressão após revascularização do miocárdio: um estudo prospectivo

INTRODUCTION: Depression during or shortly after hospitalization elevated two to three times the risk of mortality or nonfatal cardiac events, significantly increasing the morbidity and mortality of these patients. OBJECTIVE: To assess the impact of revascularization on symptoms of depression in patients with coronary artery disease. METHODS: A prospective cohort study of 57 patients of both sexes undergoing coronary artery bypass grafting between June 2010 and June 2011. We used the SF-36 to assess quality of life, and the Beck Depression Inventory to detect depressive symptoms, applied preoperatively and six months. RESULTS: The prevalence of patients aged 60-69 years was 22 patients (38.60%), 39 men (68.42%), 26 described themselves as mixed race (45.61%), 16 literate (28.07 %) and 30 married (52.63%). The beck depression inventory score demonstrated increased after revascularization: 15 patients mild (26.32%) at time zero to 17 (29.82%) after. And with moderate, seven patients (12.28%) before and 10 (17.54%) after. In the categories of individuals with decreased minimum degree of 32 (56.14%) to 28 (49.12%), and severe of three (5.26%) for two (3.51%) patients. Association was observed between beck depression inventory, gender, age, lifestyle, comorbidities and quality of life. CONCLUSION: There was a high prevalence of elevated beck depression inventory scores, lowest scores of depressive symptoms among men and association between the improvement of quality of life scores and beck depression inventory.

INTRODUÇÃO: A depressão durante ou logo após a hospitalização, eleva duas a três vezes o risco de mortalidade ou eventos cardíacos não-fatais, aumentando sensivelmente a morbimortalidade desses pacientes. OBJETIVO: Avaliar o impacto da revascularização do miocárdio nos sintomas de depressão de pacientes portadores de doença arterial coronariana. MÉTODOS: Estudo de coorte prospectivo de 57 pacientes de ambos os sexos, submetidos à revascularização do miocárdio, entre junho de 2010 e junho de 2011. Foram utilizados os questionários SF-36 para avaliar a qualidade de vida, e o Inventário de Depressão Beck para detectar sintomas depressivos, aplicados no pré-operatório e após seis meses. RESULTADOS: A prevalência de pacientes na faixa etária de 60 a 69 anos foi de 22 (38,60%) pacientes, 39 (68,42%) homens, 26(45,61%) autodeclarados pardos, 16 (28,07%) alfabetizados e 30 (52,63%) casados. O escore Inventário de Depressão Beck demonstrou aumento após a revascularização de 15 (26,32%) pacientes em grau leve no momento zero para 17 (29,82%) após. E com grau moderado, sete (12,28%) pacientes antes e 10 (17,54%) após. Nas categorias de indivíduos com grau mínimo houve redução de 32 (56,14%) para 28 (49,12%) e grave de três (5,26%) para dois (3,51%) pacientes. Observou-se associação entre Inventário de Depressão Beck, sexo, idade, estilo de vida, comorbidades e a qualidade vida. CONCLUSÃO: Observou-se elevada prevalência de escores elevados de inventário de depressão Beck, piores escores de sintomas depressivos entre homens e associação entre a melhoria dos escores de qualidade de vida e o Inventário de Depressão Beck.