Heart rate and pulse pressure at rest are major prognostic markers of early postoperative complications after coronary bypass surgery.

Aboyans V, Frank M, Nubret K, Lacroix P, Laskar M.

In this study of 1022 patients admitted for non-urgent coronary artery bypass grafting the authors aimed to assess the predictive value of preoperative HR and PP in the 30-day postoperative period. Heart rate was measured on ECG at admission and preoperative pulse pressure was obtained by the difference of the mean of three consecutive systolic and diastolic blood pressures. The primary outcome combined the 30-day postoperative mortality, myocardial infarction and stroke or transient ischemic attack.

Those meeting the primary outcome (n=146) had a significantly higher HR and a higher proportion presented a PP >70 mmHg. After adjustments for age, gender, systolic blood pressure, preoperative beta-blocker therapy, left ventricular ejection fraction <0.40, unstable cardiac status, redo surgery, peripheral arterial disease, renal failure, and combined vascular surgery, both HR and PP >70 mmHg remained significant risk predictors.

European Journal of Cardiothoracic Surgery 2008;33: 971-6

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