Cognitive Outcomes Three Years After Coronary Artery Bypass Surgery: A Comparison of On-Pump Coronary Artery Bypass Graft Surgery and Nonsurgical Controls

2005 ◽  
Vol 79 (4) ◽  
pp. 1201-1209 ◽  
Author(s):  
Ola A. Selnes ◽  
Maura A. Grega ◽  
Louis M. Borowicz ◽  
Sarah Barry ◽  
Scott Zeger ◽  
...  
2019 ◽  
Vol 8 ◽  
pp. 204800401986212 ◽  
Author(s):  
Redoy Ranjan ◽  
Dipannita Adhikary ◽  
Sabita Mandal ◽  
Sanjoy Kumar Saha ◽  
Kamrul Hasan ◽  
...  

Introduction European System for Cardiac Operative Risk Evaluation (EuroSCORE) was developed to identify patients who may have a greater postoperative risk for adverse effects following adult cardiac surgery. This study evaluated the discriminatory potential of using the EuroSCORE system in predicting the early, as well as late, postoperative outcomes following coronary artery bypass graft surgery in Bangladesh. Methods A total of 865 patients who underwent isolated coronary artery bypass graft surgery were evaluated with the EuroSCORE risk scoring system. Moreover, we also compared the discriminatory potentials between the EuroSCORE II and the original logistic EuroSCORE. Results Operative mortality was best predicted by EuroSCORE II (area under the curve (AUC) 0.863, Brier score 0.030) compared to the original logistic EuroSCORE (AUC 0.849, Brier score 0.033). However, the overall expected-to-observed mortality ratio for EuroSCORE II was 1.1, whereas the observed ratio for the original logistic EuroSCORE was 1.7. EuroSCORE II was predictive of an intensive care unit stay of five days or more (AUC 0.786), prolonged inotropes use (AUC 0.746), stroke (AUC 0.646), de novo dialysis (AUC 0.810), and low output syndrome (AUC 0.715). Moreover, a high EuroSCORE II quintile significantly predicted the risk for late mortality (p < 0.0001). Conclusions EuroSCORE has an important role in predicting the early, as well as late, postoperative outcomes following coronary artery bypass surgery. However, the performance of EuroSCORE II is significantly better than the original logistic EuroSCORE in predicting postoperative morbidity and mortality after isolated coronary artery bypass graft surgery among Bangladeshi patients.


Author(s):  
Kiran Sarathy ◽  
George A. Wells ◽  
Kuljit Singh ◽  
Etienne Couture ◽  
Aun Yeong Chong ◽  
...  

Background The optimal antiplatelet strategy for patients with acute coronary syndromes who require coronary artery bypass surgery remains unclear. While a more potent antiplatelet regimen will predispose to perioperative bleeding, it is hypothesized that through “platelet quiescence,” ischemic protection conferred by such therapy may provide a net clinical benefit. Methods and Results We compared patients undergoing coronary artery bypass surgery who were treated with a more potent antiplatelet inhibition strategy with those with a less potent inhibition through a meta‐analysis. The primary outcome was all‐cause mortality after bypass surgery. The analysis identified 4 studies in which the antiplatelet regimen was randomized and 6 studies that were nonrandomized. Combining all studies, there was an overall higher mortality with weaker strategies compared with more potent strategies (odds ratio, 1.38; 95% CI, 1.03–1.85; P =0.03). Conclusions Our findings support the concept of platelet quiescence, in reducing mortality for patients with acute coronary syndrome requiring coronary artery bypass surgery. This suggests the routine up‐front use of potent antiplatelet regimens in acute coronary syndrome, irrespective of likelihood of coronary artery bypass graft.


2013 ◽  
Vol 2 (6) ◽  
Author(s):  
M. Hadadzade ◽  
S. Forouzania ◽  
S. Mirhoseini ◽  
H. Peighambari ◽  
N. Naserzade ◽  
...  

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