Estimation of cardiosurgical intervention risk according to EuroSCORE in patients with acute coronary syndrome and different gallbladder conditions before coronary artery bypass grafting.

INTRODUCTION

Estimation of cardiosurgical intervention risk according to EuroSCORE is an important aspect of cardiosurgery. EuroSCORE allows prediction of the probability of a post-operational fatal outcome.

AIM

To estimate the influence of gallbladder condition on the prognosis after coronary artery bypass grafting (CABG) and and the interactions between metabolic background and cardiosurgical intervention risk.

MATERIAL AND METHODS

We investigated data of 98 patients with unstable angina pectoris or acute myocardial infarction before planned CABG. These patients were divided into the following groups according to their gallbladder condition: intact bladder; bile sludge or cholesterosis; bent gallbladder body; gallbladder neck deformations or cholecystitis; cholelithiasis; history of cholecystectomy.

RESULTS

The mean cardiosurgical intervention risk score according to the EuroSCORE system in our patients was 6.03 ±0.62%. It was significantly higher in patients with low serum bilirubin levels. There were direct correlations between the risk score result and presence of left ventricular dilatation ( = 0.31, < 0.05) and fasting glucose level ( = 0.82, < 0.01), as well as with means of other parameters, i.e., left atrial dimension, right ventricular size, grade of stenosis of anterior interventricular branch of left coronary artery, serum levels of total cholesterol, β-lipoproteins, bilirubin and potassium.

CONCLUSIONS

These correlations suggest that the EuroSCORE results estimated before surgery may be used as a simple informative prognostic criterion of intra-operational cardiac mortality and also as a marker of structural and functional heart condition and metabolic background. However, these correlations were different in patients with different gallbladder conditions.