CABG Surgery In Patients Research Articles

Knowledge and Self – efficacy for Post CABG Surgery patients

Knowledge and Self – efficacy for Post CABG Surgery patients

Six-minute walk test distance at time of hospital discharge is strongly and independently associated with all-cause mortality following cardiac surgery

We investigated the impact of distance covered in the six-minute walk test (6mWT) before being discharged from the hospital after cardiac surgery on the risk of all-cause mortality. Our study included 1127 patients who underwent cardiac surgery and then took part in a standardised physiotherapist-supervised inpatient rehabilitation programme during 2007–2017. The percentage of the predicted 6mWT distance, and the lower limit of normal distance was calculated based on individual patients’ age, sex, and body mass index. We used Cox regression with adjustment for confounders to determine multivariable-adjusted hazard ratios (HRs) for mortality. Over a median follow-up period of 6.4 (IQR: 3.5–9.2) years, 15% (n = 169) patients died. We observed a strong and independent inverse association between 6mWT distance and mortality, with every 10 m increase in distance associated to a 4% reduction in mortality (HR: 0.96, 95% CI 0.94–0.98, P < 0.001). Those in the top tertile for predicted 6mWT performance had a 49% reduced risk of mortality (HR: 0.51, 95% CI 0.33–0.79) compared to those in the bottom tertile. Patients who met or exceeded the minimum normal 6mWT distance had 36% lower mortality risk (HR: 0.64, 95% CI 0.45–0.92) compared to those who did not meet this benchmark. Subgroup analysis showed that combined CABG and valve surgery patients walked less in the 6mWT compared to those undergoing isolated CABG or valve surgeries, with a significant association between 6mWT and mortality observed in the isolated procedure groups only. In conclusion, the longer the distance covered in the 6mWT before leaving the hospital, the lower the risk of mortality.

Coronary Artery Bypass Surgery in Patients Receiving Dual Antiplatelet Therapy and the Impact of Preoperative Vitamin D Levels During COVID-19 Pandemic: An Observational Single Center Study

Background: The COVID-19 pandemic has led to a surge in catheter-based interventions as elective surgeries were postponed. However, there has been a simultaneous rise in emergency CABG surgeries due to stent thrombosis or catheter-related complications. The potential impact of vitamin D on the immune system has also gained attention during the pandemic. We aim to investigate the impact of preoperative dual anti-platelet (DAPT) usage and vitamin D levels of those patients who underwent CABG on postoperative outcomes. Materials and methods: This retrospective study was conducted between March 23, 2020, and December 30, 2021. The study included 63 patients who underwent elective and emergency CABG while on dual antiplatelet therapy, d vitamin levels were obtained from all the patients preoperatively. Results: 51 of the 63 patients were males and 12 were females. The mean age was 62.69 ± 8.43 years. 15 patients (24%) were on Clopidogrel and Acetylsalicylic acid (ASA) and 48 patients (76%) were on Ticagrelor and ASA preoperatively. Off-pump CABG was performed in 21 patients (33%). One patient had a stroke (1.6 %). The amount of drainage was significantly higher in patients using Ticagrelor and (ASA) (p=0.015). The mean vitamin D level was 13.94±5.24 ng/ml ranging from 3.38 ng/ml to 24.99 ng/ml, Vitamin D levels were significantly lower in female patients compared to males (p=0.004). Conclusion: CABG surgery in patients receiving DAPT presents unique challenges and requires careful management to minimize bleeding complications. Additionally, maintaining adequate vitamin D levels preoperatively may improve postoperative outcomes.

Assessment of the Heart's Left and Right Ventricles (EF and TAPSE) in CABG Surgery Patients before and after Cardiac Rehabilitation.

Post-coronary artery bypass grafting (post-CABG) is a beneficial procedure for cardiac patients. However, without an appropriate cardiac rehabilitation (CR) program, patient care may be inadequate, leading to recurrent hospitalizations and heart failure. This study aims to assess the effects of a CR program on left ventricular ejection fraction (LVEF) and tricuspid annular plane systolic excursion (TAPSE) measures in post-CABG patients at Amir-almomenin, kordkuy Hospital, Golestan, Iran. This descriptive-analytic study included 100 patients who underwent post-CABG surgery in the second half of 2020, and whose complete information was available in their medical files. An echocardiologist assessed the LVEF and TAPSE of the patients. After one month of CR procedures, these measures were reevaluated and recorded. The CR program consisted of 5 to 10 sessions of physiotherapy per patient, with 2 or 3 sessions conducted per week. It involved a four-phase therapy that included light sports activities such as running and jogging on a treadmill at a CR clinic. Data analysis was performed using SPSS software version 18. The data analysis of this study suggests that implementing a CR program for post- CABG patients can have beneficial effects. CR significantly increased the patients' LVEF, but the increase in TAPSE was not statistically significant. Furthermore, both male and female patients showed improved LVEF after the CR program. There was a non-significant inverse relationship between hospitalization duration and LVEF. Statistically, older patients had a significantly longer duration of hospitalization compared to younger patients. Completion of a cardiac rehabilitation program leads to significant improvement in left ventricular function, while the improvement in right ventricular function is relatively modest. Moreover, a significant proportion of patients were able to resume their normal daily activities after completing the rehabilitation phase.

Preoperative Vitamin Supplemental Therapy might improve Postoperative Outcome of CABG Surgery Patients

Preoperative Vitamin Supplemental Therapy might improve Postoperative Outcome of CABG Surgery Patients

Right ventricular and pulmonary artery pulse pressure variation and systolic pressure variation for the prediction of fluid responsiveness: an interventional study in coronary artery bypass surgery patients.

Predicting fluid responsiveness is essential when treating surgical or critically ill patients. When using a pulmonary artery catheter, pulse pressure variation and systolic pressure variation can be calculated from right ventricular and pulmonary artery pressure waveforms. We conducted a prospective interventional study investigating the ability of right ventricular pulse pressure variation (PPVRV) and systolic pressure variation (SPVRV) as well as pulmonary artery pulse pressure variation (PPVPA) and systolic pressure variation (SPVPA) to predict fluid responsiveness in coronary artery bypass (CABG) surgery patients. Additionally, radial artery pulse pressure variation (PPVART) and systolic pressure variation (SPVART) were calculated. The area under the receiver operating characteristics (AUROC) curve with 95%-confidence interval (95%-CI) was used to assess the capability to predict fluid responsiveness (defined as an increase in cardiac index of > 15%) after a 500 mL crystalloid fluid challenge. Thirty-three patients were included in the final analysis. Thirteen patients (39%) were fluid-responders with a mean increase in cardiac index of 25.3%. The AUROC was 0.60 (95%-CI 0.38 to 0.81) for PPVRV, 0.63 (95%-CI 0.43 to 0.83) for SPVRV, 0.58 (95%-CI 0.38 to 0.78) for PPVPA, and 0.71 (95%-CI 0.52 to 0.89) for SPVPA. The AUROC for PPVART was 0.71 (95%-CI 0.53 to 0.89) and for SPVART 0.78 (95%-CI 0.62 to 0.94). The correlation between pulse pressure variation and systolic pressure variation measurements derived from the different waveforms was weak. Right ventricular and pulmonary artery pulse pressure variation and systolic pressure variation seem to be weak predictors of fluid responsiveness in CABG surgery patients.

Prehabilitation in patients awaiting elective coronary artery bypass graft surgery – effects on functional capacity and quality of life: a randomized controlled trial

Objective: To determine the impact of an exercise-based prehabilitation (EBPrehab) program on pre- and postoperative exercise capacity, functional capacity (FC) and quality of life (QoL) in patients awaiting elective coronary artery bypass graft surgery (CABG). Design: A two-group randomized controlled trail. Setting: Ambulatory prehabilitation. Subjects: Overall 230 preoperative elective CABG-surgery patients were randomly assigned to an intervention (IG, n = 88; n = 27 withdrew after randomization) or control group (CG, n = 115). Intervention: IG: two-week EBPrehab including supervised aerobic exercise. CG: usual care. Main measures: At baseline (T1), one day before surgery (T2), at the beginning (T3) and at the end of cardiac rehabilitation (T4) the following measurements were performed: cardiopulmonary exercise test, six-minute walk test (6MWT), Timed-Up-and-Go Test (TUG) and QoL (MacNew questionnaire). Results: A total of 171 patients (IG, n = 81; CG, n = 90) completed the study. During EBPrehab no complications occurred. Preoperatively FC (6MWTIG: 443.0 ± 80.1 m to 493.5 ± 75.5 m, P = 0.003; TUGIG: 6.9 ± 2.0 s to 6.1 ± 1.8 s, P = 0.018) and QoL (IG: 5.1 ± 0.9 to 5.4 ± 0.9, P < 0.001) improved significantly more in IG compared to CG. Similar effects were observed postoperatively in FC (6MWDIG: Δ-64.7 m, pT1–T3 = 0.013; Δ+47.2 m, pT1–T4 < 0.001; TUGIG: Δ+1.4 s, pT1–T3 = 0.003). Conclusions: A short-term EBPrehab is effective to improve perioperative FC and preoperative QoL in patients with stable coronary artery disease awaiting CABG-surgery. ID: NCT04111744 (www.ClinicalTrials.gov; Preoperative Exercise Training for Patients Undergoing Coronary Artery Bypass Graft Surgery- A Prospective Randomized Trial)

A prospective five-year cohort study of undiagnosed sleep apnea in patients undergoing coronary artery bypass graft surgery.

We aimed to study prospectively the nature and effect of sleep apnea-hypopnea syndrome (SAHS) in patients undergoing coronary artery bypass graft (CABG) surgery over five years of follow-up. Patients undergoing CABG surgery (N.=145) were assessed longitudinally (baseline, 1 year, and 5 years post-surgery) using the 'STOP-BANG' screen of sleep apnea risk. Additionally, all patients had a preoperative multiple-channel sleep-study, providing acceptable data for an obstructive and central apnea, and desaturation index in 97 patients. Preoperatively, over half (63%) of patients obtained an apnea-hypopnea index score (combining apnea types) in the moderate-severe range for SAHS, and STOP-BANG threshold score (>3/8) was reached by most (95%) patients. Despite some improvement in 'STOP symptoms' at 1-year follow-up, most patients (98%) remained at risk of SAHS at 5 years post-surgery. There was an underlying and chronic relationship between STOP-BANG score and cardiac symptoms at both baseline and 5-year follow-up. Additionally, SAHS variables were associated with greater incidence of acute postoperative events, and generally with increased length of stay on the intensive care unit. We confirm that SAHS is common in CABG-surgery patients, presenting additional clinical challenges and cost implications. The underlying pathophysiology is complex, including upper airway obstruction and cardiorespiratory changes of heart failure. In patients presenting for CABG-surgery, we show chronic susceptibility to SAHS, likely associated with traditional risk factors e.g. obesity but perhaps also with gradual decline in heart function itself. Superimposed on this, there is potential for exacerbated risk of morbidity at the time of CABG surgery itself.

Fentanyl - Based Cardiac Anesthesia Provides Higher Recovery Compared with Morphine in Elective CABG Surgery Patients

Background : High-dose opioid anesthesia during cardiac surgery has been the mainstay of cardiacanesthesia for decades due to its ability to preserve hemodynamic stability and attenuate hormonal andmetabolic response to surgical stress. The hypothesis of this study is that the use of fentanyl as part of abalanced anesthetic would lead to improved patient health status and recovery during the first 3 daysafter cardiac surgery with CPB compared with morphine. Quality of recovery was assessed using theQoR-40 questionnaire administered preoperatively and daily on postoperative days 1–3. Hemodynamicvariables, duration of tracheal intubation, organ morbidities, intensive care unit (ICU) and hospitallength of stay were evaluated. Methods: This comparative randomized double blind study was conducted in the department ofcardiothoracic vascular anaesthesia and critical care of Apollo Hospitals,Dhaka on 100 patientsundergoing elective CABG. Study period was (January-July), 2019. The study was approved by theinstitutional review board, and informed consent was obtained from all subjects. One hundred patientspresenting for elective CABG surgery, between the ages of 18 and 79, were enrolled in the study. Exclusioncriteria included (1) concurrent valvular surgery or the presence of valvular disease, (2) reoperativeprocedures, (3) unstable angina or elevated cardiac enzymes within 48 hours of surgery, (4) morphine orfentanyl allergy, (5) the need for an intra-aortic balloon pump or inotropic agents preoperatively, (6)psychiatric or central nervous system disturbances precluding completion of the QoR-40. Results: Compared with patients given morphine, those receiving fentanyl had higher global QoR-40scores on postoperative days 1 (174.8 vs 162.5, P 0.001), 2 (175 vs 166.1, P 0.001), and 3 (178.1 vs 167.3,P 0.001). Differences between the groups were observed in the QoR-40 dimensions of emotional state,physical comfort, and pain . Postoperative visual analog scale pain scores, use of pain medication in theICU and surgical ward, and postoperative febrile reactions were reduced significantly in the fentanylgroup . No differences between the groups were noted in duration of tracheal intubation,ICU and hospitallength of stay, or postoperativecomplications. Conclusion: Continuous intravenous infusions of fentanyl have been used to provide intraoperativeanalgesia also give good-to-excellent postoperative analgesia furthermore early extubation and the qualityof postoperative recovery in cardiac surgical patients can be enhanced when fentanyl is used as part of abalanced anesthetic. JBSA 2020; 33(1): 28-35

To Study the Response of Treadmill Walking and Cycle Ergometer on the Hemodynamic Changes of Post CABG Surgery Patients during Immediate Post-Operative Days

To Study the Response of Treadmill Walking and Cycle Ergometer on the Hemodynamic Changes of Post CABG Surgery Patients during Immediate Post-Operative Days

Myocardial viability and CABG surgery: a Bayesian appraisal of STICH

The myocardial viability substudy from the STICH trial has reaffirmed the 10-year survival benefit of CABG surgery in patients with left ventricular dysfunction, but whether myocardial viability must be present for the long-term benefits of revascularization to be realized remains inconclusive.

Effect of Levosimendan Infusion 24 Hours Before CABG Surgery in Patients with Impaired Left Ventricular Function on the Need for Postoperative IABP

Background: Due to their unfavorable outcome, patients with impaired left ventricular function undergoing CABG surgery (LVEF ≤ 35%) are in a real need for optimization of their preoperative status in order to achieve the best possible results. In this retrospective comparative study we analysis our results in patients with impaired LV function after using Levosimendan as a continuous infusion 24 hours prior to CABG surgery regarding the need for postoperative IABP. Patients and methods: We included in this study 103 patients with LVEF ≤ 35% that underwent coronary artery bypass grafting with or without repair of ischemic mitral regurgitation and received Levosimendan infusion 24 hours before surgery in the period between January 2016 and January 2019 in 2 hospitals (Group A). These data were compared to another matched control group of 98 patients with similar conditions that were operated in the same hospitals over a previous period of 3 years but received no Levosimendan infusion preoperatively (Group B). Results: There was a statistically significant difference in the postoperative results in favor of group A regarding the need for IABP application (P-value = 0.013). However there were no statistically significant differences between both groups in concern of duration of inotropic support (P-value = 0.40), duration of mechanical ventilation (P-value = 0.30), total ICU (P-value = 0.20) and hospital stays (P-value = 0.40), incidence of postoperative atrial fibrillation (P-value = 0.50), incidence of major adverse effects, and in-hospital mortality (P-value = 0.20). There was only one in-hospital mortality in each group. Conclusion: According to our study, infusion of Levosimendan 24 hours prior to CABG surgery in patients with impaired left ventricular contractility is safe and effective in reducing the need of IABP application. However Levosimendan infusion did not affect significantly postoperative coarse, incidence of major adverse effects, and in-hospital mortality.

A Study to assess the effectiveness of Honey Warm Water on level of Constipation among patients undergone CABG with Constipation in selected Hospitals at Rajkot

A study to assess the effectiveness of honey warm water on level of constipation among patients undergone cabg with constipation in selected hospitals at Rajkot. The objectives of the study were a) To assess the level of constipation among patients undergone CABG. b) To assess the effectiveness of honey warm water on level of constipation among patients undergone CABG. c)To find out the association between level of constipation and after taking honey warm water with their selected demographic variables. The research approach selected for the study was quantitative research approach and Quasi-experimental study Time-series research design. The study was conducted at selected hospital at Rajkot. The conceptual framework for this study was based on Weidnbach nursing practice model. The study had been conducted in Unicare Hospital, Rajkot. Non-probability purposive sampling technique had been adopted to select the desired samples. The sample size was 40. As a part of intervention, honey warm water was administered for 10 ml of honey will take mixed with 100 ml of warm water. At the early morning when the patients having empty stomach this mixture of honey warm water was provided to the post CABG surgery patients for three days, to get the best result. The data was collected through Constipation Assessment Scale. The collected data were analyzed through descriptive statistics (frequency and percentage) and inferential statistics ('Annova-test ’and chi-square) to test the hypothesis. The study shows that the calculated chi square value is below the level of tabulated value at the level of 0.05. Thus stated the hypothesis is rejected & null hypothesis was accepted. So its inferred that there is no significant association between the demographic variables and level of constipation among post-operative CABG patients. The obtained ‘F ’value 26.752 at 0.001 level hence the hypothesis was accepted. It is inferred that honey warm water was effective in reducing level of constipation among post-operative CABG.

Serum Levels of miR-155, miR-326, and miR-133b as Early Diagnostic Biomarkers for the Detection of Human Acute Heart Allograft Rejection in Comparison with Serum Cardiac Troponin T.

Acute heart allograft rejection occurs as a result of antibody-mediated rejection that presents during the first month after transplantation. Finding a non-invasive biomarker is essential for diagnosis of heart allograft rejection. In this research, we intended to compare expression levels of several microRNAs across cardiac troponin T levels between rejected patients (who died before one month following transplantation), non-rejected patients (who survived for at least one month after transplantation), and non-transplanted patients (CABG surgery patients). Serum levels of miR-155, miR-326, and miR-133b were evaluated by the q-RT-PCR method. Furthermore, cardiac troponin T levels were measured by a highly sensitive electrochemiluminescence assay. Finally, the data were analyzed by independent sample t-test using SPSS 21® computer software.Results: It was observed that miR-326 and miR-155 expression levels increased after 24h and 72h of surgery in rejected patients compared with the two other groups, but these increases were not statistically significant. Moreover, the decrease in miR-133b expression level was non-significant after transplantation in the rejected group compared with the non-rejected group. However, cTnT levels in rejected patients increased significantly compared with the other groups (P < .05). After ROC curve analysis, the cTnT marker with the most area under the curve (AUC = 1.00, 95% confidence interval, 1.00 to 1.00; P = .006), had the best discriminatory power, and among microRNAs, miR-326 had the largest area under curve (AUC = 0.81), and consequently the highest discriminatory power. We demonstrated that troponin T can be a more efficient biomarker than miRNAs for early prediction of human death caused by acute heart rejection, and the ROC curves analysis verified this finding.

Intraoperative ECMO Implantation Reduces Mortality of CABG Surgery in Patients with STEMI

Intraoperative ECMO Implantation Reduces Mortality of CABG Surgery in Patients with STEMI

Mortality and Thromboembolic Events in Hypercoagulable States From ROTEM-Thromboelastometry in Patients Who Undergo Coronary Bypass Surgery

Objective: To test the hypothesis that post CABG thromboembolic events and MACCE at 1, 3, 6,and 12 months after surgery are related to the pre-surgical TEG status and investigate the prevalence of preoperative hypercoagulability in the high risk population in Thailand assessed by Rotational Thromboelastography (ROTEM). Method: This is a prospective cohort study consecutively assessing pump CABG surgery patients. Hypercoagulability was defined as any clotting time (CT) clot formation time (CFT), amplitude 10 min after CT (A10), or maximum clot firmness (MCF) in ROTEM measurement above the upper normal limit of EXTEM, INTEM and FIBTEM in the worldwide population. Results: Forty per cent of patients show a state of hypercoagulability in terms of ROTEM. The majority of hypercoagulable patients were female. ROTEM data illustrate the significant upward trends of A10, A20 and MCF above the upper limit in hypercoagulable patients with levels of 90%, 68% and 95% in EXTEM, INTEM AND FIBTEM, respectively. The mortality and MACCE event rates were slightly increased in hypercoagulable patients both at 30 days and at 1 year with statistical significance in all event rates at the 1-year follow-up. In univariate terms, ROTEM hypercoagulability is also associated with uneventful combinations in the follow-up at 1 year. Conclusion: Hypercoagulability was found in 43% of on pump CABG patients and is associated with high risk for mortality and morbidity in the 1-year follow-up.

National administrative data produces an accurate and stable risk prediction model for short-term and 1-year mortality following cardiac surgery

ObjectivesVarious risk models exist to predict short-term risk-adjusted outcomes after cardiac surgery. Statistical models constructed using clinical registry data usually perform better than those based on administrative datasets. We constructed a procedure-specific risk prediction model based on administrative hospital data for England and we compared its performance with the EuroSCORE (ES) and its variants. MethodsThe Hospital Episode Statistics (HES) risk prediction model was developed using administrative data linked to national mortality statistics register of patients undergoing CABG (35,115), valve surgery (18,353) and combined CABG and valve surgery (8392) from 2008 to 2011 in England and tested using an independent dataset sampled for the financial years 2011–2013. Specific models were constructed to predict mortality within 1-year post discharge. Comparisons with EuroSCORE models were performed on a local cohort of patients (2580) from 2008 to 2013. ResultsThe discrimination of the HES model demonstrates a good performance for early and up to 1-year following surgery (c-stats: CABG 81.6%, 78.4%; isolated valve 78.6%, 77.8%; CABG & valve 76.4%, 72.0%), respectively. Extended testing in subsequent financial years shows that the models maintained performance outside the development period. Calibration of the HES model demonstrates a small difference (CABG 0.15%; isolated valve 0.39%; CABG & valve 0.63%) between observed and expected mortality rates and delivers a good estimate of risk. Discrimination for the HES model for in-hospital deaths is similar for CABG (logistic ES 79.0%) and combined CABG and valve surgery (logistic ES 71.6%) patients and superior for valve patients (logistic ES 70.9%) compared to the EuroSCORE models. The C-statistics of the EuroSCORE models for longer periods are numerically lower than that of the HES model. ConclusionThe national administrative dataset has produced an accurate, stable and clinically useful early and 1-year mortality prediction after cardiac surgery.

Bridging the Transition from Hospital to Home: Effects of the VITAL Telehealth Program on Recovery for CABG Surgery Patients and their Caregivers

The purpose of this randomized trial was to determine whether coronary artery bypass graft surgery patients and their caregivers who received telehealth follow-up had greater improvements in anxiety levels from pre-surgery to 3 weeks after discharge than did those who received standard care. Secondary outcomes included changes in depressive symptoms and patients' contacts with physicians. No group differences were noted in changes in patients' anxiety and depressive symptoms, but patients in the telehealth group had fewer physician contacts (p = .04). Female caregivers in the telehealth group had greater decreases in anxiety than those in standard care (p < .001), and caregivers of both genders in the telehealth group had greater decreases in depressive symptoms (p = .03).

The effectiveness of nurse-led cardiac rehabilitation programs following coronary artery bypass graft surgery: a systematic review protocol

Review question/objective Do nurse-led cardiac rehabilitation programs following coronary artery bypass graft surgery improve patients' health-related quality of life and reduce hospital readmissions? Inclusion Criteria Types of participants This systematic review will consider studies that include male or female, post–CABG surgery patients, aged 60 years and older with a history of cardiovascular disease (CVD). Types of interventions(s) This systematic review will consider studies that evaluate nurse-led CR programs. Comparator(s) Non-participation in a nurse-led CR program, or usual care. Types of Outcomes The outcomes of interest for this systematic review will focus on HRQoL and readmissions. Measures of HRQoL will be focusing on various validated instruments, such as the Medical Outcomes Study 36 Item Short Form (SF-36) and disease specific Seattle Angina Questionnaire (SAQ). Hospital readmission will be considered as the total number of cardiac-related admissions in the follow-up period following the CABG intervention. Any validated and published scales measuring readmission rates, for example the General Health Questionnaire, will be included.

Is leukocytosis a predictor for recurrence of ischemic events after coronary artery bypass graft surgery? A cohort study.

Objective. Studies have shown that inflammation plays an important role in pathogenesis of coronary artery disease. The present study was designed to evaluate the role of high WBC count before CABG in predicting the risk of ischemic events after CABG. Methods and Results. This prospective study was carried out on 380 patients who underwent CABG surgery. Ninety seven patients (25.5%) had recurrent ischemic event. Mean WBC count before CABG surgery in patients with recurrent ischemic event was 7267 mic/lit ± 1863, which was significantly higher than the others, with a mean WBC count of 6721 mic/lit ± 1734 (P = 0.011). Patients with a WBC count more than 6000 mic/lit were at the highest risk for recurrent ischemic event (OR = 2.11, 95% CI = 1.18–3.44, P = 0.009). After adjustment for age, sex, family history, smoking, hyperlipidemia, Logestic Euro score, post opretive enzyme release (CK.mb), arterial graft and BMI, the relationship between the group with WBC count higher than 6000 mic/lit and recurrent of ischemic event remained significant (OR = 2.25, 95% CI = 1.2 to 4, P = 0.005). Conclusions. High WBC count before CABG surgery is an independent risk factor for ischemic events one year after the surgery.