[Surgical revascularization in patients with acute coronary syndromes: early outcome]. / Chirurgiczna rewaskularyzacja serca u chorych z ostrymi zespolami wiencowymi: wyniki wczesne.

OBJECTIVE: Between January 1 2001 and June 30 2002, 2204 CABG procedures were performed in our institution. 110 patients underwent urgency CABG within six hours of ACS. We analyzed their short-term results. METHODS: 55 patients underwent CABG for UAP, 31 for STEMI and 24 for NSTEMI. In the control group, 55 patients underwent elective revascularization. Preoperative, intraoperative, and postoperative data were analyzed. RESULTS: Hospital mortality was 12.9%, 8.3%, 7.3% and 1.9% for groups with STEMI, NSTEMI, UAP and stable angina, respectively. Independent predictors of early mortality, in order of decreasing importance, were: preoperative extracardiac arteriopathy (p = 0.0002), cardiac arrest befor CABG (p = 0.0003), preoperative shock (p = 0.003), STEMI (p = 0.03) and LVEF < 40% (p = 0.03). CONCLUSIONS: CABG procedures should be a standard part of ACS treatment. Patients with UAP and NSTEMI can be safely operated during the early course of ACS. CABG can be performed with acceptable early-term risk in patients with STEMI and hemodynamic instability.