A severity score for preoperative risk factors as related to morbidity and mortality in patients with coronary artery disease undergoing myocardial revascularization surgery

1992 ◽  
Vol 7 (6) ◽  
pp. 950-958 ◽  
Author(s):  
Fawzy G. Estafanous ◽  
Thomas Higgins ◽  
Floyd Loop
Keyword(s):  
Risk Factors ◽  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Severity Score ◽  
Myocardial Revascularization ◽  
Morbidity And Mortality ◽  
Preoperative Risk ◽  
Preoperative Risk Factors ◽  
Artery Disease ◽  
Revascularization Surgery

scholarly journals Predictive potential assessment of preoperative risk factors for atrial fibrillation in patients with coronary artery disease after coronary artery bypass grafting

2020 ◽  
Vol 35 (4) ◽  
pp. 128-136
Author(s):  
K. I. Shakhgeldyan ◽  
V. Y. Rublev ◽  
B. I. Geltser ◽  
B. O. Shcheglov ◽  
V. G. Shirobokov ◽  
...  
Keyword(s):  
Risk Factors ◽  
Atrial Fibrillation ◽  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Coronary Artery Bypass Grafting ◽  
Artery Bypass ◽  
Bypass Grafting ◽  
Preoperative Risk ◽  
Preoperative Risk Factors ◽  
Artery Disease

Introduction. Postoperative atrial fibrillation (POAF) is one of the most common complications of coronary artery bypass grafting (CABG) and occurs in 25–65% of patients.Aim. The study aimed to assess the predictive potential of preoperative risk factors for POAF in patients with coronary artery disease (CAD) after CABG based on machine learning (ML) methods.Material and Methods. An observational retrospective study was carried out based on data from 866 electronic case histories of CAD patients with a median age of 63 years and a 95% confidence interval [63; 64], who underwent isolated CABG on cardiopulmonary bypass. Patients were assigned to two groups: group 1 comprised 147 (18%) patients with newly registered atrial fibrillation (AF) paroxysms; group 2 included 648 (81.3%) patients without cardiac arrhythmia. The preoperative clinical and functional status was assessed using 100 factors. We used statistical analysis methods (Chi-square, Fisher, Mann – Whitney, and univariate logistic regression (LR) tests) and ML tests (multivariate LR and stochastic gradient boosting (SGB)) for data processing and analysis. The models’ accuracy was assessed by three quality metrics: area under the ROC-curve (AUC), sensitivity, and specificity. The cross-validation procedure was performed at least 1000 times on randomly selected data.Results. The processing and analysis of preoperative patient status indicators using ML methods allowed to identify 10 predictors that were linearly and nonlinearly related to the development of POAF. The most significant predictors were the anteroposterior dimension of the left atrium, tricuspid valve insufficiency, ejection fraction <40%, duration of the P–R interval, and chronic heart failure of functional class III–IV. The accuracy of the best predictive multifactorial model of LR was 0.61 in AUC, 0.49 in specificity, and 0.72 in sensitivity. The values of similar quality metrics for the best model based on SGB were 0.64, 0.6, and 0.68, respectively.Conclusion. The use of SGB made it possible to verify the nonlinearly related predictors of POAF. The prospects for further research on this problem require the use of modern medical care methods that allow taking into account the individual characteristics of patients when developing predictive models.

scholarly journals Assessment of coronary artery disease patient eligibility to phase 3 cardiac rehabilitation in the outpatient settings after myocardial revascularization

2021 ◽  
Vol 10 (1) ◽  
pp. 16-25
Author(s):  
O. Yu. Korennova ◽  
E. P. Prihodko ◽  
Yu. E. Yukhina ◽  
M. V. Savchenko ◽  
E. A. Turusheva ◽  
...  
Keyword(s):  
Risk Factors ◽  
Blood Pressure ◽  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Cardiac Rehabilitation ◽  
Myocardial Revascularization ◽  
Phase 3 ◽  
Rehabilitation Team ◽  
Exercise Rehabilitation ◽  
Artery Disease

Aim. To determine the clinical factors affecting the timely reference of patients with coronary artery disease after myocardial revascularization to Phase 3 cardiac rehabilitation.Methods. 773 patients with coronary artery disease (CAD) who underwent myocardial revascularization were recruited in a study. Of them, 77 (9.96%) underwent coronary artery bypass grafting and 696 (90.04%) underwent PCI. Within 1 month of discharge, patients were examined by a cardiologist in the outpatient hospital and then referred to the cardiac rehabilitation team to assess their eligibility. The eligibility for exercise rehabilitation was assessed based on the results of general examination, clinical and laboratory findings. The prevalence of absolute and relative contraindications to exercise rehabilitation was measured.Results. 10% of CAD patients after myocardial revascularization had absolute contraindications and 29.6% had relative contraindications to exercise rehabilitation. The presence of relative contraindications (exaggerated blood pressure response (>80/100 mm Hg) to exercise or a decrease in systolic blood pressure ≥20 mm Hg, ventricular extrasystole and tachycardia, paroxysmal tachyarrhythmias in response to exercise, active gastroduodenal ulcer, and less than 1 month after its exacerbation, moderate heart valvular disease (aortic stenosis), decompensated carbohydrate metabolism disorders) required the management of risk factors limiting patients on the participation in exercise rehabilitation. The routing of CAD patients after myocardial revascularization at Phase 3 cardiac rehabilitation was developed and introduced in the Clinical Cardiological Dispensary in the Omsk region.Conclusion. Most patients with CAD after myocardial revascularization should be referred to exercise rehabilitation. These patients rarely have absolute contraindications (about 10%). Despite relative contraindications are rather high (about 30%), risk factors limiting patient participation in exercise rehabilitation are managed successfully. Optimal routing of patients contributes to their prompt recruiting to cardiac rehabilitation. Effective management of cardiovascular risk factors allows recruiting more patients in exercise rehabilitation.

scholarly journals STUDY OF RISK FACTORS,CLINICAL PROFILES AND ANGIOGRAPHIC PATTERNS IN PATIENTS OF CORONARY ARTERY DISEASE IN A TERTIARY CARE CENTRE IN KOLKATA

2021 ◽  
pp. 41-45
Author(s):  
Saroj Mandal ◽  
Vignesh. R ◽  
Sidnath Singh
Keyword(s):  
Risk Factors ◽  
Coronary Artery Disease ◽  
Risk Factor ◽  
Coronary Artery ◽  
Coronary Angiography ◽  
Tertiary Care ◽  
Morbidity And Mortality ◽  
Common Symptom ◽  
Clinical Profiles ◽  
Artery Disease

BACKGROUND:Coronary artery disease (CAD) is one of the most common causes of mortality and morbidity in both developed and developing countries. It is a leading cause of death in India, and its contribution to mortality is rising. Considering the increasing burden of coronary artery disease and its mortality and the usefulness of identifying risk factors, studying the clinical profile and angiographic pattern will help us intervene the disease at various levels which can help control the morbidity and mortality of coronary artery diease. MATERIALS AND METHOD: The present study was conducted in the Department of Cardiology,IPGMER & SSKM Hospital,Kolkata during the period of January 2019 to December 2019.This is a hospital based observational prospective study with prospective data collection,where all patients of coronary artery disease who had undergone coronary angiography has been taken into consideration to find out the risk factors,clinical profiles and angiographic patterns in coronary artery disease patients in Kolkata. RESULTS: Maximum patients were present in the age group 51-60 years of age.Mean age is 56.7+11.6sd.Male patients were 70% and female patients were 30%.Most common symptom was chest pain,90% of patients had it during the time of presentation.The next frequent symptom was shortness of breath which was seen in 52% of patients. Most common risk factor was smoking which was seen in 58% of patients.Next frequent risk factor being hypertension seen in 43.5% of patients.Obesity was seen in 59.2% of patients.On coronary angiography,40% of patients had Single vessel CAD,27.3% had double vessel CAD,23.5% had Double vessel CAD,6.5% had Non-Significant CAD and 2.7% had Normal coronaries(recanalized epicardial coronaries).LAD was involved in 73.5% of patients,51.7 % had RCA involved,43.5 % had LCX involved and LMCA was involved in 1.7% of patients. CONCLUSION:Smoking and hypertension are the most common risk factors.Single vessel disease is the most common angiographic pattern.Risk factors should be addressed properly to decrease the morbidity and mortality of coronary artery disease

scholarly journals Coronary Artery Bypass Graft for Left Main Coronary Artery Disease

2015 ◽  
Vol 22 (2) ◽  
pp. 25-29
Author(s):  
Husain H. Jabbad
Keyword(s):  
Risk Factors ◽  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Left Main Coronary Artery ◽  
Bypass Graft ◽  
Main Group ◽  
Morbidity And Mortality ◽  
Left Main ◽  
Main Coronary Artery Disease ◽  
Artery Disease

Because left main coronary artery disease carries a high risk of morbidity and mortality, this retrospective study will review the data and results of surgical management of left main coronary artery disease, in King Abdulaziz University Hospital. 448 patients underwent coronary bypass graft into two groups, left main group (50) patients and non-left main group (398) patients. Preoperative data, risk factors and cardiac catheterization findings were compared in between the two groups in addition to perioperative morbidity and mortality. Patients in the left main group were younger in age with significantly lower ejection fraction and more risk factors (hypertension, dyslipidemia, and smoking). In our study the left main group patients had higher mortality than non-left main patients [4 patients = 8%, 6 patients = 1.8%]; the most common cause of perioperative mortality in the left main group was low cardiac output state, and the most common complications were perioperative myocardial infarction and prolonged ventilation. The higher mortality and morbidity associated with surgery for left main coronary artery disease can be explained by the higher risk profi le, the need of urgent surgery and critical preoperative status.  

scholarly journals Coronary Artery Bypass Graft for Left Main Coronary Artery Disease

2015 ◽  
Vol 22 (2) ◽  
pp. 25-29
Author(s):  
Husain H. Jabbad
Keyword(s):  
Risk Factors ◽  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Left Main Coronary Artery ◽  
Bypass Graft ◽  
Main Group ◽  
Morbidity And Mortality ◽  
Left Main ◽  
Main Coronary Artery Disease ◽  
Artery Disease

Because left main coronary artery disease carries a high risk of morbidity and mortality, this retrospective study will review the data and results of surgical management of left main coronary artery disease, in King Abdulaziz University Hospital. 448 patients underwent coronary bypass graft into two groups, left main group (50) patients and non-left main group (398) patients. Preoperative data, risk factors and cardiac catheterization findings were compared in between the two groups in addition to perioperative morbidity and mortality. Patients in the left main group were younger in age with significantly lower ejection fraction and more risk factors (hypertension, dyslipidemia, and smoking). In our study the left main group patients had higher mortality than non-left main patients [4 patients = 8%, 6 patients = 1.8%]; the most common cause of perioperative mortality in the left main group was low cardiac output state, and the most common complications were perioperative myocardial infarction and prolonged ventilation. The higher mortality and morbidity associated with surgery for left main coronary artery disease can be explained by the higher risk profi le, the need of urgent surgery and critical preoperative status.  

Elevated level of circulatory sTLT1 induces inflammation through SYK/MEK/ERK signalling in coronary artery disease

2019 ◽  
Vol 133 (22) ◽  
pp. 2283-2299
Author(s):  
Apabrita Ayan Das ◽  
Devasmita Chakravarty ◽  
Debmalya Bhunia ◽  
Surajit Ghosh ◽  
Prakash C. Mandal ◽  
...  
Keyword(s):  
Risk Factors ◽  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Chronic Inflammation ◽  
Ex Vivo ◽  
Human Subjects ◽  
Critical Role ◽  
Atherosclerotic Cardiovascular Disease ◽  
Tnf Α ◽  
Artery Disease

Abstract The role of inflammation in all phases of atherosclerotic process is well established and soluble TREM-like transcript 1 (sTLT1) is reported to be associated with chronic inflammation. Yet, no information is available about the involvement of sTLT1 in atherosclerotic cardiovascular disease. Present study was undertaken to determine the pathophysiological significance of sTLT1 in atherosclerosis by employing an observational study on human subjects (n=117) followed by experiments in human macrophages and atherosclerotic apolipoprotein E (apoE)−/− mice. Plasma level of sTLT1 was found to be significantly (P<0.05) higher in clinical (2342 ± 184 pg/ml) and subclinical cases (1773 ± 118 pg/ml) than healthy controls (461 ± 57 pg/ml). Moreover, statistical analyses further indicated that sTLT1 was not only associated with common risk factors for Coronary Artery Disease (CAD) in both clinical and subclinical groups but also strongly correlated with disease severity. Ex vivo studies on macrophages showed that sTLT1 interacts with Fcɣ receptor I (FcɣRI) to activate spleen tyrosine kinase (SYK)-mediated downstream MAP kinase signalling cascade to activate nuclear factor-κ B (NF-kB). Activation of NF-kB induces secretion of tumour necrosis factor-α (TNF-α) from macrophage cells that plays pivotal role in governing the persistence of chronic inflammation. Atherosclerotic apoE−/− mice also showed high levels of sTLT1 and TNF-α in nearly occluded aortic stage indicating the contribution of sTLT1 in inflammation. Our results clearly demonstrate that sTLT1 is clinically related to the risk factors of CAD. We also showed that binding of sTLT1 with macrophage membrane receptor, FcɣR1 initiates inflammatory signals in macrophages suggesting its critical role in thrombus development and atherosclerosis.

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