Comparing Risk-adjusted Hospital Mortality for CABG and AMI Patients

The objectives of this study were to compare the risk-adjusted mortality of coronary artery bypass graft (CABG) and acute myocardial infarction (AMI) patients simultaneously in six hospitals in Seoul, Korea, and to investigate the relationship between these performance measures by developing a predictive model of mortality. The medical records of 749 AMI and 564 CABG patients were reviewed. A predictive model was developed using logistic regression, including 170 variables selected as risk factors for risk adjustment. The validity of our predictive model was demonstrated to be within an acceptable range. The results showed that one hospital with a significantly low AMI mortality rate also had a low CABG mortality rate, while another hospital with a significantly high AMI mortality rate also had a high CABG mortality rate. Our results implied that hospitals providing good-quality medical management of coronary artery disease also provided a good-quality surgical service.

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Mammography as Screening for Coronary Artery Disease

The American Surgeon ◽

10.1177/000313480707300717 ◽

2007 ◽

Vol 73 (7) ◽

pp. 717-721 ◽

Cited By ~ 1

Author(s):

Jonathan R. Adkins ◽

T. Clark Gamblin ◽

D. Benjamin Christie ◽

Carol Collings ◽

Martin L. Dalton ◽

...

Keyword(s):

Coronary Artery Disease ◽

Coronary Artery ◽

Medical Records ◽

Screening Tool ◽

Artery Bypass ◽

Screening Mammography ◽

Screening Mammogram ◽

Screening Mammograms ◽

Artery Disease ◽

The Relationship

Coronary artery disease (CAD) is the leading cause of death in American women. Screening mammograms are recommended for women starting at age 40 for the early detection of breast cancer. An additional benefit of this routine screening tool may be to detect breast arterial calcifications (BAC) as a possible sign of CAD. The purpose of this study was to determine further the relationship between mammographically detected BAC and CAD. The medical records of 44 women who had undergone coronary artery bypass grafting at our institution over 5 years were reviewed. These mammograms were examined for evidence of BAC. For all women included in the study, 18 of 44 (41%) had evidence of BAC on screening mammogram. This was statistically significant ( P < 0.0001) compared with the prevalence of BAC reported in the general population in previous studies. Most were also overweight (61.1%), had hypertension (88.8%), and hypercholesterolemia (55.5%). This is the first study to look at the direct correlation between patients with known CAD requiring revascularization and BAC. Perhaps women with BAC seen on screening mammography should undergo further workup for CAD, with the potential benefit of early intervention.

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Perioperative outcomes of coronary artery bypass graft surgery in Johannesburg, South Africa

Journal of Cardiothoracic Surgery ◽

10.1186/s13019-020-01385-8 ◽

2021 ◽

Vol 16 (1) ◽

Author(s):

Samantha Reiche ◽

Dineo Mpanya ◽

Katharina Vanderdonck ◽

Shungu Mogaladi ◽

Palesa Motshabi-Chakane ◽

...

Keyword(s):

South Africa ◽

Coronary Artery Disease ◽

Coronary Artery ◽

Mortality Rate ◽

Perioperative Complications ◽

Artery Bypass ◽

Bypass Graft ◽

Artery Bypass Graft ◽

Cabg Surgery ◽

Artery Disease

Abstract Background The perioperative complications in patients with coronary artery disease undergoing coronary artery bypass graft (CABG) surgery have been reported predominantly from developed countries, with a paucity of data from sub-Saharan Africa. We aim to report on the clinical characteristics and perioperative complications in patients with obstructive coronary artery disease, managed with CABG surgery at a tertiary academic hospital in Johannesburg, South Africa. Methods We retrospectively reviewed data from adult patients who underwent CABG surgery during a 17-year period (January 2000 – December 2017). Data was collected from the cardiothoracic surgery department’s pre- and postoperative reports, the cardiology department’s medical records, and anaesthesiology’s intra-operative reports. We collected demographic, biochemical, clinical, surgical, echocardiographic, and angiographic data. Outcomes data collected included perioperative complications and mortality. Results We analysed 1218 consecutive patient records. The study cohort consisted of 951 (78.1%) males, and the mean age was 60.1 ± 10.1 years. During the study period, 137 (11.2%) patients demised with cardiac and sepsis-related causes of death accounting for 49.6 and 37.2%, respectively. Other perioperative complications included excessive bleeding in 222 (18.2%), prolonged ventilation (exceeding 48 h) in 139 (11.4%), and sternal sepsis in 125 (10.3%). On univariate logistic regression analysis, advanced age, a lower left ventricular ejection fraction, smoking, increased cardiopulmonary bypass (CPB) time, and a higher European System for Cardiac Operative Risk Evaluation (EuroSCORE) II were all significantly associated with mortality. The EuroSCORE II [OR: 0.15 95%CI: 0.09–0.22; p = 0.000], and prolonged CPB time [OR: 0.01 CI: 0.00–0.02; p = 0.000] were independent predictors of in-hospital all-cause mortality. Conclusions In our study, the crude perioperative mortality rate was 11.2%. Our mortality rate was significantly higher than the mortality rates reported in other developed and developing countries. To better understand the factors driving this high mortality rate, a prospective outcomes registry has been initiated, and this promises to inform on our contemporary mortality and morbidity outcomes.

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Factors associated with return to work after coronary artery bypass grafting (CABG)

European Journal of Preventive Cardiology ◽

10.1093/eurjpc/zwab061.360 ◽

2021 ◽

Vol 28 (Supplement_1) ◽

Author(s):

A Raynaldo

Keyword(s):

Diabetes Mellitus ◽

Logistic Regression ◽

Coronary Artery ◽

Return To Work ◽

Coronary Artery Bypass ◽

Functional Capacity ◽

Artery Bypass ◽

Bypass Graft ◽

Factors Associated ◽

Cabg Patients

Abstract Funding Acknowledgements Type of funding sources: None. Background. Postoperative CABG patients will generally experience improvement in symptoms and functional capacity. Post-CABG patients are expected to be productive again in order to have a positive impact on both patient and the society socio-economically, in addition to other parameters such as morbidity, mortality and serious adverse events. Purpose to determine the factors that associated with return to work in CABG patients in one General Hospital. Methods. We analyzed data from Adam Malik Hospital registry of 68 patients who had undergone CR after coronary artery bypass graft (CABG) in 2017-2020. The outcomes assessed were work status in 6 month after CABG. Patients’ characteristics, sociodemographic, clinical parameters of functional capacity using 6 minutes of walk test (6MWT), T2DM, Hypertension and cholesterol level were assessed. Factors associated with return to work were identified using multivariable logistic regression. Results We identified 68 patients undergoing isolated CABG (2017–2020). One year after discharge for CABG, 40 (58.8%) patients had returned to the workforce. Factors associated with return to work were identified using bivariate logistic regression. Diabetes mellitus (odds ratio, 10.192; 95% confidence interval, 0.063–0.515). Conclusion Almost 2 from 3 patients after CABG returned to work within 6 months. Diabetes mellitus and functional capacity were associated with a lower likelihood of returning to work.

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Prognostic utility of early systolic lengthening by speckle tracking in patients undergoing coronary artery bypass graft

European Heart Journal - Cardiovascular Imaging ◽

10.1093/ehjci/jeaa356.181 ◽

2021 ◽

Vol 22 (Supplement_1) ◽

Author(s):

P Brainin ◽

S Lindberg ◽

F Olsen ◽

S Pedersen ◽

A Iversen ◽

...

Keyword(s):

Coronary Artery ◽

Coronary Artery Bypass Graft ◽

Speckle Tracking ◽

Prognostic Value ◽

Artery Bypass ◽

Bypass Graft ◽

Artery Bypass Graft ◽

Positive Strain ◽

All Cause Mortality ◽

Cabg Patients

Abstract Funding Acknowledgements Type of funding sources: Public grant(s) – National budget only. Main funding source(s): The Independent Research Fund Denmark Background Early systolic lengthening (ESL), a paradoxical stretch of myocardial fibers, has been linked to myocardial viability and contractile dysfunction. We assessed the long-term prognostic potential of ESL in coronary artery bypass graft (CABG) patients. Methods We retrospectively included patients (n = 709; mean age 68 years; 85% men) who underwent speckle tracking echocardiography (median 15 days) prior to CABG. Endpoints were cardiovascular death (CVD) and all-cause mortality. We assessed amplitude of ESL (%), defined as peak positive strain, and duration of ESL (ms), determined as time from Q-wave on the ECG to peak positive strain. We applied Cox proportional hazards models adjusted for the clinical risk tool, EuroSCORE II. Results During median follow-up of 3.8 years [IQR 2.7 to 4.9 years], 45 (6%) experienced CVD and 80 (11%) died. In survival analyses adjusted for EuroSCORE II, amplitude of ESL was associated with CVD (HR 1.37 [95%CI 1.13 to 1.66], P = 0.001) and all-cause mortality (HR 1.31 [95%CI 1.13 to 1.54], P = 0.001). Similar findings applied to duration of ESL and CVD (HR 1.17 [95%CI 1.08 to 1.26], P < 0.001) and all-cause mortality (HR 1.14 [95%CI 1.07 to 1.21], P < 0.001). The prognostic value of ESL amplitude was modified by sex (P interaction < 0.05), such that it was greater in women for both endpoints (Figure 1A-B). When adding ESL duration to EuroSCORE II, the net reclassification index improved significantly for both CVD and all-cause mortality. Conclusions Assessment of ESL provides independent and incremental prognostic information in addition to the EuroSCORE II for CVD and all-cause mortality in CABG patients. The prognostic value was greater in women. Abstract Figure. Prognostic value of ESL amplitude by sex

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