PO23-747 REGULAR AND CHRONIC USE OF STATIN PREVENTS ATRIAL FIBRILLATION IN THE EARLY POSTOPERATIVE PERIOD OF ELECTIVE CARDIAC SURGERY

2007 ◽  
Vol 8 (1) ◽  
pp. 199
Author(s):  
R.J. Alves ◽  
R.N. Campos ◽  
E.S. Hara ◽  
F. Haag ◽  
K. Nakiri
Keyword(s):  
Atrial Fibrillation ◽  
Cardiac Surgery ◽  
Postoperative Period ◽  
Early Postoperative Period ◽  
Elective Cardiac Surgery ◽  
Chronic Use

Frailty syndrome as an independent predictor of unfavorable outcome in patients undergoing coronary artery bypass grafting

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
K Krivoshapova ◽  
O.L Barbarash ◽  
E.A Wegner ◽  
N.A Terentyeva ◽  
I.I Grigorieva ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Coronary Artery ◽  
Coronary Artery Bypass Grafting ◽  
Coronary Artery Bypass ◽  
Postoperative Period ◽  
Artery Bypass ◽  
Early Postoperative Period ◽  
Bypass Grafting ◽  
Artery Bypass Grafting ◽  
Risk Of Death

Abstract Purpose To assess the prevalence of frailty in the preoperative period and to evaluate its effect on the risk of complications and adverse outcomes in patients undergoing coronary artery bypass grafting (CABG). Methods 303 patients undergoing preoperative management for elective primary CABG were recruited in the study. The study cohort was divided into three groups depending on the PRISMA-7 scores suggesting the presence or absence of frailty and the presence of prefrailty. Statistical analysis was performed using the commercially available software package STATISTICA 8.0.360.0 for Windows (StatSoft, Inc., USA) and SPSS Statistics v. 17.0.0. Results 46 (15%) patients had frailty, while 49 (16%) patients were diagnosed with prefrailty. 208 (69%) patients did not have any signs of frailty. All three groups had significant age differences, therefore only elderly patients aged of 67.0±6.5 years with frailty were allocated for subsequent analysis (prefrailty group - 62.3±7.4 years old, patients without frailty - 60.0±7.7 years, p=0.003). Patients with frailty or prefrailty more often suffered from diabetes mellitus (patients without frailty - 19.2%, prefrailty group - 30.6% and frailty group - 28.3%, p=0.05), arterial hypertension (69.2%, 93.9% and 95.7%, respectively, p<0.001), atrial fibrillation or flutter (7.2%, 14.3% and 19.6%, respectively, p=0.03), chronic heart failure class 3–4 (7.2%, 10.2% and 8.7%, respectively, p=0.002), and peripheral arterial disease (22.6%, 38.8% and 58.7%, respectively, p<0.001). Three groups were comparable in main clinical and demographic parameters. There were no significant differences found in the incidence of postoperative atrial fibrillation or flutter (15.9%, 8.2% and 6.5%, respectively, p=0.07) and infections (1.9%, 0% and 4.3%, respectively, p=0.640). The incidence of myocardial infarction in the intra- and early postoperative period after CABG did not differ significantly between the groups (0.5%, 2% and 0%, respectively, p=0.328) as well as the incidence of stroke (2.4%, 2% and 0%, respectively, p=0.640). Patients with frailty and prefrailty had significantly higher cerebrovascular and cardiovascular mortality compared to those without frailty (8.2%, 2.2% and 0.5%, respectively, p=0.001). Conclusion Almost 15% of patients referred to CABG suffered from frailty. The presence of prefrailty or frailty increases the risk of death in the early postoperative period after CABG. Funding Acknowledgement Type of funding source: None

Epicardial Adipose Tissue and Postoperative Atrial Fibrillation

2021 ◽  
Author(s):  
Petraglia Laura ◽  
Conte Maddalena ◽  
Comentale Giuseppe ◽  
Cabaro Serena ◽  
Campana Pasquale ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Adipose Tissue ◽  
Cardiac Surgery ◽  
Epicardial Adipose Tissue ◽  
Perioperative Period ◽  
Postoperative Atrial Fibrillation ◽  
Serum Samples ◽  
Monocyte Chemoattractant Protein 1 ◽  
Elective Cardiac Surgery ◽  
Increased Risk

Abstract Background. Atrial fibrillation (AF) often occurs after cardiac surgery and is associated to increased risk of stroke and mortality. Several evidence support the important role of inflammation in the pathogenesis of postoperative atrial fibrillation (POAF). It is known that an increased volume and a pro-inflammatory phenotype of epicardial adipose tissue (EAT) are both associated with AF onset in non surgical context. In the present study, we aim to evaluate whether also POAF occurrence may be triggered by an exalted production of inflammatory mediators from EAT.Methods. The study population was composed of 105 patients, with no history of paroxysmal or permanent AF, undergoing elective cardiac surgery. After clinical evaluation, all patients performed an echocardiographic study including the measurement of EAT thickness. Serum samples and EAT biopsies were collected before surgery. Levels of 10 inflammatory cytokines were measured in serum and EAT conditioned media. After surgery, cardiac rhythm was monitored for 7 days.Results. Forty-four patients (41.3%) developed POAF. As regard to cardiovascular therapy, only statin use was significantly lower in POAF patients (65.1% vs. 84.7%; p-0.032). Levels of Monocyte Chemoattractant Protein-1 (MCP-1), in both serum and EAT, were significantly higher in POAF patients (130.1 pg/ml vs. 68.7 pg/ml; p = < 0.001; 322.4 pg/ml vs. 153.4 pg/ml; p = 0.028 respectively). EAT levels of IL-6 were significantly increased in POAF patients compared to those in sinus rhythm (126.3 pg/ml vs. 23 pg/ml; p = < 0.005).ConclusionHigher EAT levels of IL6 and MCP1 are significantly associated with the occurrence of POAF. Statin therapy seems to play a role in preventing POAF. These results might pave the way for a targeted use of these drugs in the perioperative period.

scholarly journals Факторы влияющие на динамику качества жизни после хирургического лечения расслоения восходящего отдела и дуги аорты

2018 ◽  
pp. 14-20
Author(s):  
O. V. Kamenskaya ◽  
A. S. Klinkova ◽  
I. Yu. Loginova ◽  
A. M. Chernyavsky ◽  
V. V. Lomivorotov ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Regression Analysis ◽  
Aortic Arch ◽  
Postoperative Period ◽  
Neurological Complications ◽  
Early Postoperative Period ◽  
Ascending Aorta ◽  
Cerebral Protection ◽  
Role Functioning ◽  
Cardiopulmonary Failure

Aim. To assess the impact of clinical and intraoperative factors on the dynamics of quality of life (QOL) after aortic prosthetics in patients with chronic dissection of ascending aorta and aortic arch.Material and methods. The study included 56 patients (mean age 50 years) with chronic DeBakey type I aortic dissection. With the help of the SF­36 questionnaire, QOL was examined before and later (12 months) after aortic prosthetics. The method of multivariate linear regression analysis was used to evaluate factors that influence the dynamics of various parameters of QOL in the late postoperative period. Results. Before the operation, patients scored from 52 points and below almost in all parameters of the questionnaire, which indicates a very low initial level of QOL. In the long­term period after aortic prosthetics, a statistically significant improvement in the following physical and psycho­emotional indicators was noted: role functioning (p=0,004); bodily pain (p=0,0001); vitality (p=0,009); social role functioning (p=0,002); emotional role functioning (p=0,009); physical health (p=0,02); mental health (p=0,03). At the same time, there was no positive change in the initial low parameters of general health and psychiatric health perceptions.According to multivariate regression analysis, the dynamics of QOL parameters in the long­term period after surgical treatment of the dissection of ascending aorta and aortic arch are affected by both intraoperative conditions (cerebral protection method) and the early postoperative period (neurological complications, cardiopulmonary failure, atrial fibrillation). Indicators such as gender, age, body weight, comorbidity, type of prosthesis of the ascending aorta, time spent in the intensive care unit, duration of artificial pulmonary ventilation do not have a significant effect on QOL in the long­term postoperative period.Conclusion. Clinical and intraoperative factors that adversely affect the dynamics of various indicators of QOL in long­term periods after prosthetics of the ascending aorta and aortic arch were: cerebral protection in conditions of deep hypothermia and craniocerebral hypothermia against the background of systemic circulatory arrest; development of neurological complications, as well as atrial fibrillation and cardiopulmonary failure in the early postoperative period.

scholarly journals CD4+CD28null T Lymphocytes are Associated with the Development of Atrial Fibrillation after Elective Cardiac Surgery

2018 ◽  
Vol 8 (1) ◽  
Author(s):  
Patrick Sulzgruber ◽  
Barbara Thaler ◽  
Lorenz Koller ◽  
Johanna Baumgartner ◽  
Arnold Pilz ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Cardiac Surgery ◽  
T Lymphocytes ◽  
Elective Cardiac Surgery

Unexplained increase in serum digoxin: a case report

1994 ◽  
Vol 40 (3) ◽  
pp. 487-492 ◽  
Author(s):  
M H Doolittle ◽  
K Lincoln ◽  
S W Graves
Keyword(s):  
Atrial Fibrillation ◽  
Cardiac Arrest ◽  
Cardiac Surgery ◽  
Case Report ◽  
Ventricular Fibrillation ◽  
Postoperative Period ◽  
High Serum ◽  
Serum Digoxin ◽  
Repeated Analysis ◽  
Analytical Approaches

Abstract We describe a patient with unexpectedly high serum digoxin after cardiac surgery. To control atrial fibrillation in the immediate postoperative period, she was given a brief trial of digoxin (four 0.25-mg doses) over 12 h. Serum digoxin 6 h later was 2.5 micrograms/L. Two days later, the patient developed ventricular fibrillation, which progressed to cardiac arrest. During or immediately after resuscitation, blood was drawn for a digoxin measurement, and the concentration reported was 9.3 micrograms/L; this result was verified by repeated analysis. Digoxin decreased rapidly and progressively to near 4.0 micrograms/L over the next several hours and thereafter decreased slowly to 1.0 microgram/L over the next 11 days, despite no digoxin being administered. The unexpectedly high digoxin raised questions about the accuracy of the digoxin measurement, particularly about the possible influence of the digoxin-like immunoreactive factor. Analytical approaches to distinguishing true digoxin from this factor and other artifacts of digoxin measurement were applied to this patient, with unanticipated results.

Incidence and risk factors for impaired mobility in older cardiac surgery patients during the early postoperative period

2014 ◽  
Vol 15 (3) ◽  
pp. 276-281 ◽  
Author(s):  
Lurdes Tse ◽  
John B Bowering ◽  
Stephan K W Schwarz ◽  
Randell L Moore ◽  
Richard Sztramko ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cardiac Surgery ◽  
Postoperative Period ◽  
Early Postoperative Period ◽  
Impaired Mobility

scholarly journals Cognitive disorders in patients after cardiac surgery

2021 ◽  
pp. 26-32
Author(s):  
A. V. Belinskyi ◽  
L. V. Rasputina ◽  
Y. M. Mostovoy ◽  
O. P. Mostova ◽  
T. D. Danilevych
Keyword(s):  
Cardiac Surgery ◽  
Postoperative Period ◽  
Cognitive Functions ◽  
Heart Defects ◽  
Cognitive Disorders ◽  
Statistical Processing ◽  
Early Postoperative Period ◽  
Cognitive Test ◽  
Before And After ◽  
Prolonged Recovery

The occurrence of cognitive disorders is a common problem after surgery. The degree of worsening of cognitive functions after surgery and anesthesia has a significant impact on the patient's health and is significantly associated with prolonged recovery in the hospital, increased morbidity and delayed functional recovery. The aim of the study was to increase the effectiveness of the diagnosis of moderate cognitive impairment and to determine its gender and age characteristics in patients before and after cardiac surgery in the early postoperative period (3 and 7 days). We examined 56 patients who underwent cardiac surgery for coronary heart disease in 37 (66.1 %) and valvular heart defects in 19 (33.9 %) patients. Assessment of cognitive functions was performed before surgery, on the 3rd and 7th day of the postoperative period. Testing was performed using the Montreal Cognitive Test. Statistical processing of the obtained data was performed on a personal computer using the statistical software package SPSS 12.0 for Windows using parametric and non-parametric methods. It was found that presence of cognitive disorders before surgery was registered in 37 (66.1 %) patients, mostly among the age of group of 60-74 years and had no gender difference. It was found that in the early postoperative period there is a significant worsening of cognitive functions in patients after cardiac surgery on 3rd day – in 45 (80.4 %), on 7th day – in 44 (78.6 %) patients, respectively.

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