IJCS | Volume 31, Nº2, March / April 2018

99 40 35 30 25 20 15 10 5 0 Present Absent Injuries Injuries Graph 1 – Prevalence of injuries Table 1 – Values of p Values for p Gender 0.508 Sedentarism 0.480 Family history for CHD 0.711 Smoker 0.101 Ex-smoker 0.674 High blood pressure 0.457 Type 2 diabetes mellitus 0.637 AMI without supra ST 0.597 Unstable angina 0.457 Dyslipidemia 0.444 Balzan et al. Atherosclerosis in the internal thoracic artery Int J Cardiovasc Sci. 2018;31(2)97-106 Original Article patients was 63 years, being 79.5% male and 20.5% female. The prevalence of 7.7% of lesions in the LITAwas identified (Graph 1). A case of LITA stenosis was observed, with > 70% of obstruction, and two lesions that made the LITA unfeasible as a graft, being collateral circulation to lower limbs through the LITA and epigastric, and a total occlusion of the subclavian artery in a portion proximal. The analysis of categorical variables using the chi-square test, and Fisher's exact test of predictors for outcomes, took into account patient's age, smoking, sedentary lifestyle, type 1 and type 2 diabetes mellitus, systemic arterial hypertension, hypercholesterolemia, previous history of AMI with supra‑ST segment elevation, without ST-segment elevation, and previous ischemic and hemorrhagic encephalic vascular accident, where no variable was shown as a predictor factor for the occurrence of outcomes (Table 1). All patients were asymptomatic with regard to LITA alterations. Discussion After the determination of the degree of coronary lesions, evidenced by the cinecoronariography examination, and based on its severity, the conduct to be taken is determined by choosing among: clinical treatment, percutaneous coronary intervention or myocardial revascularization surgery. The criteria for indication of myocardial revascularization surgery are based on two main objectives, being them the improvement of survival and improvement of symptoms. When we think of improved survival, the main indication (Class IB) is for patients with significant stenosis (> 50% of the diameter) of the trunk of the left coronary artery. 8-9 When analyzing other anatomical regions out of the trunk of the left coronary artery, there is a surgical indication for improvement of survival (Class IB) in cases of significant stenosis (> 70% of diameter) in three main coronary arteries, without involvement of the proximal region of the anterior descending artery, or if there is involvement of the proximal region of the anterior descending artery, the associationwith a major coronary artery. 10-11 Still related to the improvement of survival, the surgical procedure is indicated for patients post cardiac arrest with presumed ischemia, mediated by ventricular tachycardias due to significant stenosis (> 70%of the diameter) in coronary artery (Class IB). 12 Related to the improvement of symptoms, there is indication for surgery