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2 . 2026

Factors of unfavorable outcome of emergency coronary artery bypass grafting in high-risk acute non-ST elevation coronary syndrome

Abstract

Introduction. Acute coronary syndrome without ST-segment elevation remains a highly relevant problem due to the heterogeneity of the patient population and the poor prognosis in high-risk groups. Identifying risk factors in this patient group will improve the outcomes of open myocardial revascularization.

Aim – to identify factors for adverse outcome of coronary artery bypass grafting in patients with high-risk non-ST-segment elevation acute coronary syndrome.

Material and methods. Over an eight-year period, 209 emergency coronary artery bypass grafting surgeries were performed within the first 24 hours of admission for high-risk non-ST-segment elevation acute coronary syndrome. Two groups were formed based on the development of major cardiovascular events in the postoperative period: those with such events (Group 1, n=20) and those with a favorable hospital course (Group 2, n=189). Univariate and multivariate regression analyses were conducted, and a prognostic model was developed.

Results. Univariate analysis showed that age over 67 years, Syntax score over 30 points, residual Syntax score over 5, GRACE over 155 points, EuroSCORE II over 4.1%, cardiopulmonary bypass time over 80 minutes, post-CABG urea over 8.3 mmol/l, and glomerular filtration rate under 67 ml/min were factors for unfavorable outcome. A prognostic model was developed, according to which the need for transfusions after surgery increased the risk of unfavorable outcome by 6.5 times, EuroSCORE II over 4.1% by 5.7 times, GRACE over 155 points by 7.4 times, and Syntax score over 30 points by 4 times

Conclusion. Independent predictors of the development of MACE after urgent coronary artery bypass grafting for high-risk acute coronary syndrome without ST segment elevation are: high risk according to the GRACE (>155 points) and EuroSCORE II (>4.1%) scales, severe coronary artery disease (SYNTAX >30 points), as well as the development of the need for transfusions of blood components in the postoperative period.

Keywords:high-risk non-ST-segment elevation acute coronary syndrome; coronary artery bypass grafting in the first 24 hours; unfavorable factors

Authors’ contribution. Study conception and design – Nishonov A.B., Tarasov R.S.; data collection and handling – Nishonov A.B., Danilovich A.I.; statistical processing – Nishonov A.B., Velieva R.M., Khorlampenko A.A.; draft manuscript preparation – Nishonov A.B., Danilovich A.I.; manuscript revision – Tarasov R.S., Velieva R.M., Khorlampenko A.A.

For citation: Nishonov A.B., Khorlampenko A.A., Velieva R.M., Danilovich A.I., Tarasov R.S. Factors of unfavorable outcome of emergency coronary artery bypass grafting in high-risk acute non-ST elevation coronary syndrome. Angiology and Vascular Surgery. Journal named after Academician A.V. Pokrovsky. 2026; 32 (2): 42–8. DOI: https://doi.org/10.33029/1027-6661-2026-32-2-42-48

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CHIEF EDITOR
CHIEF EDITOR
Yuri V. Belov
Academician of the Russian Academy of Sciences Doctor of Medical Sciences, Professor, President of the Russian Society of Angiologists and Vascular Surgeons

 

In accordance with the decision of the Presidium of the Russian Society of Angiologists and Vascular Surgeons, the journal "Angiology and Vascular Surgery" will be named after Academician A.V. Pokrovsky starting from No. 2/2022.

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