scholarly journals Incidence of postoperative, major, adverse cardiac events in patients undergoing carotid endarterectomy: A single-center, retrospective study

2022 ◽  
Vol 10 ◽  
pp. 205031212110703
Author(s):  
Aphichat Suphathamwit ◽  
Chutima Leewatchararoongjaroen ◽  
Pongprueth Rujirachun ◽  
Kittipatr Poopong ◽  
Apichaya Leesakul ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Heart Failure ◽  
Congestive Heart Failure ◽  
Retrospective Study ◽  
Confidence Interval ◽  
Carotid Endarterectomy ◽  
Major Adverse Cardiac Events ◽  
Single Center ◽  
Cardiac Events ◽  
Adverse Cardiac Events

Objective: This study aimed to determine the incidence of postoperative major adverse cardiac events for patients undergoing carotid endarterectomy. Methods: This single-center, retrospective study recruited 171 carotid endarterectomy patients between January 1999 and June 2018. Patients who received a carotid endarterectomy in conjunction with other surgery were excluded. The primary outcomes were the incidences of major adverse cardiac events (comprising myocardial infarction, significant arrhythmias, congestive heart failure, and cardiac death) within 7 days, 7–30 days, and > 30 days–1 year, postoperatively. The secondary outcomes were the factors related to major adverse cardiac events and the incidence of postoperative stroke. The patients’ charts were reviewed, and direct contact was made with them to obtain information on their status post discharge. Results: The incidences of major adverse cardiac events within 7 days, 7–30 days, and >30 days–1 year of the carotid endarterectomy were 3.5% of patients (95% confidence interval: 0.008–0.063), 1.2% (95% confidence interval: 0.004–0.028), and 1.8% (95% confidence interval: 0.002–0.037), respectively. The major adverse cardiac events occurring within 7 days were arrhythmia (2.3% of patients), cardiac arrest (1.8%), myocardial infarction (1.2%), and congestive heart failure (1.2%), while the corresponding postoperative stroke rate was 4.7%. Conclusion: The 7-day incidence of major adverse cardiac events after the carotid endarterectomy was 3.5%. The most common major adverse cardiac event during that period was cardiac arrhythmia.

Cardiac Risk of Noncardiac Surgery in Patients with Asymmetric Septal Hypertrophy

1996 ◽  
Vol 85 (2) ◽  
pp. 254-259 ◽  
Author(s):  
Michael J. Haering ◽  
Mark E. Comunale ◽  
Robert A. Parker ◽  
Edward Lowenstein ◽  
Pamela S. Douglas ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Heart Failure ◽  
Congestive Heart Failure ◽  
Cardiac Risk ◽  
Noncardiac Surgery ◽  
Major Surgery ◽  
Cardiac Events ◽  
Adverse Cardiac Events ◽  
Asymmetric Septal Hypertrophy ◽  
Septal Hypertrophy

Background Many data are available regarding cardiac risk in patients with coronary artery disease undergoing noncardiac surgery, but few data are available regarding risk for patients with hypertrophic cardiomyopathy and asymmetric septal hypertrophy. Methods Seventy-seven patients with asymmetric septal hypertrophy were identified in whom an echocardiogram had been performed within 24 months of noncardiac surgery. Patients' charts were reviewed for data regarding surgical operations, including length of surgery, type of anesthesia, and intravascular monitoring used. Data regarding adverse perioperative cardiac events also were gathered. Results Forty percent (n = 31) of patients had one or more adverse perioperative cardiac events, including one patient who had a myocardial infarction and ventricular tachycardia that required emergent cardioversion. There were no perioperative deaths. All 31 patients had minor outcomes. Of the 77 patients, perioperative congestive heart failure developed in 12 (16%). Factors associated with adverse cardiac events were increasing length of surgical time (P < 0.01) major surgery (P < 0.05), and intensity of monitoring (P < 0.05). Age, gender, resting outflow tract gradient, systolic anterior motion of the anterior mitral leaflet, prior myocardial infarction, severity of mitral regurgitation, type of anesthetic, septal thickness, and the interval between echocardiogram and surgery were not associated with the occurrence of adverse cardiac events. Conclusion Patients with asymmetric septal hypertrophy undergoing noncardiac surgery have a high incidence of adverse cardiac events, frequently manifested as congestive heart failure. However, irreversible cardiac morbidity and mortality was extremely low. Important independent risk factors for adverse outcome in all patients include major surgery and increasing duration of surgery.

scholarly journals Higher risk of major adverse cardiac events after acute myocardial infarction in patients with schizophrenia

Open Heart ◽  
2020 ◽  
Vol 7 (2) ◽  
pp. e001286
Author(s):  
Rubina Attar ◽  
Axel Wester ◽  
Sasha Koul ◽  
Svend Eggert ◽  
Christoffer Polcwiartek ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Heart Failure ◽  
Acute Myocardial Infarction ◽  
Cox Regression ◽  
Major Adverse Cardiac Events ◽  
Chronic Obstructive ◽  
High Risk Population ◽  
Cardiac Events ◽  
Adverse Cardiac Events ◽  
All Cause Mortality

BackgroundPatients with schizophrenia are a high-risk population due to higher prevalences of cardiovascular risk factors and comorbidities that contribute to shorter life expectancy.PurposeTo investigate patients with and without schizophrenia experiencing an acute myocardial infarction (AMI) in relation to guideline recommended in-hospital management, discharge medications and 5-year major adverse cardiac events (MACE: composite of all-cause mortality, rehospitalisation for reinfarction, stroke or heart failure).MethodsAll patients with schizophrenia who experienced AMI during 2000–2018 were identified (n=1008) from the nationwide Swedish Web-system for Enhancement and Development of Evidence-based care in Heart disease Evaluated According to Recommended Therapies registry and compared with AMI patients without schizophrenia (n=2 85 325). Kaplan-Meier survival curves and multivariable Cox regression models were used to compare the populations.ResultsPatients with schizophrenia presented with AMI approximately 10 years earlier (median age 64 vs 73 years), and had higher prevalences of diabetes, heart failure and chronic obstructive pulmonary disease. They were less likely to be invasively investigated or discharged with aspirin, P2Y12 inhibitors, ACE inhibitors/angiotensin II receptor blockers, beta-blockers and statins (all p<0.005). AMI patients with schizophrenia had higher adjusted risk of MACE (aHR=2.05, 95% CI 1.63 to 2.58), mortality (aHR=2.38, 95% CI 1.84 to 3.09) and hospitalisation for heart failure (aHR=1.39, 95% CI 1.04 to 1.86) compared with AMI patients without schizophrenia.ConclusionPatients with schizophrenia experienced an AMI almost 10 years earlier than patients without schizophrenia. They less often underwent invasive procedures and were less likely to be treated with guideline recommended medications at discharge, and had more than doubled risk of MACE and all-cause mortality. Improved primary and secondary preventive measures, including adherence to guideline recommendations, are warranted and may improve outcome.

scholarly journals Post PCI with stenting Follow-Up in Women for 7 Years in Public Sector Tertiary Care Cardiac Unit. Retrospective Study

2020 ◽  
Vol 5 (2) ◽  
Keyword(s):  
Myocardial Infarction ◽  
Heart Failure ◽  
Menopausal Status ◽  
Major Adverse Cardiac Events ◽  
Hormonal Contraceptives ◽  
Cardiac Events ◽  
Adverse Cardiac Events ◽  
Long Term Follow Up

Introduction: Despite of the fact that there is continual improvement in diagnostic and therapeutic procedures in catherization Lab introduction of better catheter techniques and new-generation stents and with the acquisition of knowledge from largescale clinical trials Still women appear to have a higher in-hospital mortality after PCI with stenting and during long term follow up specially in developing countries of South Asia the, Reason could be multi-factorial in women. The objectives: The goals of treatment in PCI with stenting in Women is to improve quality of life, to prevent CHD from becoming symptomatic, prevent myocardial infarction, cardiac death and heart failure, the approaches to achieve these goals at the societal or individual level in this regards differ among various countries, the data that have been published are often limited due to the relatively small number of western women. It is important to collect data in under developed countries on outcomes of long term follow up of women with AMI after PCI with stenting to change the global perception of treatment of women with myocardial infarction. Material and Method: Out of 3300 patients, underwent successful PCI with stenting during 2010 to 2016 in Cath Lab of cardiology department of Dow University of Health and Sciences Karachi Pakistan , 577 patients with Sciences Karachi Pakistan, 577 patients with Myocardial infarction within 7 days were included in study and they constitute the present followup population. Additional data regarding noncardiac comorbid diseases and Risk factors were obtained along with crucial aspects of women’s health, such as menopausal status, use of hormonal contraceptives, Follow-up was planned after 1 month and then with annualy for 7 years. The primary end point of study were the long-term rate of major adverse cardiac events (i.e. death, Infarction, and repeat revascularization). The secondary end points were the individual components of the major adverse cardiac events and stent thrombosis. Result: This observational study was conducted by reviewing the record of cases performed and getting information on follow up visits of patients for 7 years from June 2010 to June 2016, out of total 3300 procedure 577 patients were included in the study who underwent PCI with stenting with in the 7 day of Myocardial infarction consisting of 346 patient from urban and 237 people from Rural areas of Sindh Balochistan Provinice of Pakistan Revascularization with stenting was performed in 313 patients 40-50 years of age followed by 219 patients 56-70 years of age in comparison to 23 in older group > 70 years and 22 in younger age < 40 years ,In 528 (91.5%)patients PCI with BMS, in 28 (4.8%)patients DES alone and in 21 (3.6%)patients with BMS and DES performed The odds of short-term mortality were significantly higher among older post - menopausal group compared to premenopausal patients <55. I3 patients (5 patients during hospitalization) and 8 patients died within 30 days after PCI. Total 57((9.8%) patient died during7 years follow up, 31 (58.5%) cases due to comorbid conditions, and remaining 27 patients death was due to myocardial infarction in 13 (39.4%). Arrhythmias in 5 (9.4%) and worsening of heart Failure in 8 (42.1%) elderly patients. Patient had complete Closure of Target Vessel, 28 (4.8%) had Re PCI on 7 years follow up and CABG was performed in 13 (2.2%). Patients main reason could be noncompliance of therapy in 71 (12.3%) in patients.

scholarly journals Major Adverse Cardiac Events and Mortality Associated with Electroconvulsive Therapy

2019 ◽  
Vol 130 (1) ◽  
pp. 83-91 ◽  
Author(s):  
Andreas Duma ◽  
Mathias Maleczek ◽  
Basil Panjikaran ◽  
Harald Herkner ◽  
Theodore Karrison ◽  
...  
Keyword(s):  
Heart Failure ◽  
Pulmonary Edema ◽  
Acute Heart Failure ◽  
Electroconvulsive Therapy ◽  
Meta Analysis ◽  
Incidence Rates ◽  
Major Adverse Cardiac Events ◽  
Cardiac Events ◽  
Total N ◽  
Adverse Cardiac Events

Abstract EDITOR’S PERSPECTIVE What We Already Know about This Topic The incidence of major adverse cardiac events after electroconvulsive therapy is not known What This Article Tells Us That Is New Major adverse cardiac events and death after electroconvulsive therapy are infrequent and occur in about 1 of 50 patients and after about 1 of 200 to 500 electroconvulsive therapy treatments Background Cardiac events after electroconvulsive therapy have been reported sporadically, but a systematic assessment of the risk is missing. The goal of this study was to obtain a robust estimate of the incidence of major adverse cardiac events in adult patients undergoing electroconvulsive therapy. Methods Systematic review and meta-analysis of studies that investigated electroconvulsive therapy and reported major adverse cardiac events and/or mortality. Endpoints were incidence rates of major adverse cardiac events, including myocardial infarction, arrhythmia, pulmonary edema, pulmonary embolism, acute heart failure, and cardiac arrest. Additional endpoints were all-cause and cardiac mortality. The pooled estimated incidence rates and 95% CIs of individual major adverse cardiac events and mortality per 1,000 patients and per 1,000 electroconvulsive therapy treatments were calculated. Results After screening of 2,641 publications and full-text assessment of 284 studies, the data of 82 studies were extracted (total n = 106,569 patients; n = 786,995 electroconvulsive therapy treatments). The most commonly reported major adverse cardiac events were acute heart failure, arrhythmia, and acute pulmonary edema with an incidence (95% CI) of 24 (12.48 to 46.13), 25.83 (14.83 to 45.00), and 4.92 (0.85 to 28.60) per 1,000 patients or 2.44 (1.27 to 4.69), 4.66 (2.15 to 10.09), and 1.50 (0.71 to 3.14) per 1,000 electroconvulsive therapy treatments. All-cause mortality was 0.42 (0.11 to 1.52) deaths per 1,000 patients and 0.06 (0.02 to 0.23) deaths per 1,000 electroconvulsive therapy treatments. Cardiac death accounted for 29% (23 of 79) of deaths. Conclusions Major adverse cardiac events and death after electroconvulsive therapy are infrequent and occur in about 1 of 50 patients and after about 1 of 200 to 500 electroconvulsive therapy treatments.

scholarly journals Pericoronary fat inflammation and Major Adverse Cardiac Events (MACE) in prediabetic patients with acute myocardial infarction: effects of metformin

2019 ◽  
Vol 18 (1) ◽  
Author(s):  
Celestino Sardu ◽  
Nunzia D’Onofrio ◽  
Michele Torella ◽  
Michele Portoghese ◽  
Francesco Loreni ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Adipose Tissue ◽  
Artery Bypass ◽  
Major Adverse Cardiac Events ◽  
Cardiac Events ◽  
Metformin Therapy ◽  
Adverse Cardiac Events ◽  
Factor Α

Abstract Background/objectives Pericoronary adipose tissue inflammation might lead to the development and destabilization of coronary plaques in prediabetic patients. Here, we evaluated inflammation and leptin to adiponectin ratio in pericoronary fat from patients subjected to coronary artery bypass grafting (CABG) for acute myocardial infarction (AMI). Furthermore, we compared the 12-month prognosis of prediabetic patients compared to normoglycemic patients (NG). Finally, the effect of metformin therapy on pericoronary fat inflammation and 12-months prognosis in AMI-prediabetic patients was also evaluated. Methods An observational prospective study was conducted on patients with first AMI referred for CABG. Participants were divided in prediabetic and NG-patients. Prediabetic patients were divided in two groups; never-metformin-users and current-metformin-users receiving metformin therapy for almost 6 months before CABG. During the by-pass procedure on epicardial coronary portion, the pericoronary fat was removed from the surrounding stenosis area. The primary endpoints were the assessments of Major-Adverse-Cardiac-Events (MACE) at 12-month follow-up. Moreover, inflammatory tone was evaluated by measuring pericoronary fat levels of tumor necrosis factor-α (TNF-α), sirtuin 6 (SIRT6), and leptin to adiponectin ratio. Finally, inflammatory tone was correlated to the MACE during the 12-months follow-up. Results The MACE was 9.1% in all prediabetic patients and 3% in NG-patients. In prediabetic patients, current-metformin-users presented a significantly lower rate of MACE compared to prediabetic patients never-metformin-users. In addition, prediabetic patients showed higher inflammatory tone and leptin to adiponectin ratio in pericoronary fat compared to NG-patients (P < 0.001). Prediabetic never-metformin-users showed higher inflammatory tone and leptin to adiponectin ratio in pericoronary fat compared to current-metformin-users (P < 0.001). Remarkably, inflammatory tone and leptin to adiponectin ratio was significantly related to the MACE during the 12-months follow-up. Conclusion Prediabetes increase inflammatory burden in pericoronary adipose tissue. Metformin by reducing inflammatory tone and leptin to adiponectin ratio in pericoronary fat may improve prognosis in prediabetic patients with AMI. Trial registration Clinical Trial NCT03360981, Retrospectively Registered 7 January 2018

Association of Stress hyperglycemia and adverse cardiac events in acute myocardial infarction – A cohort study

2021 ◽  
Vol 22 ◽  
Author(s):  
Annu Rajpurohit ◽  
Bharat Sejoo ◽  
Rajendra Bhati ◽  
Prakash Keswani ◽  
Shrikant Sharma ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Heart Failure ◽  
Acute Myocardial Infarction ◽  
Blood Glucose ◽  
Clinical Outcomes ◽  
P Value ◽  
Cardiac Events ◽  
Stress Hyperglycemia ◽  
Adverse Cardiac Events ◽  
Hba1c Levels

Background: Stress hyperglycemia is a common phenomenon in patients presenting with acute myocardial infarction (MI). We aim to evaluate the association of stress hyperglycemia at the time of hospital presentation and adverse cardiac events in myocardial infarction during the course of hospital stay. Methods: Subjects with age ≥18 years with acute MI were recruited on hospital admission and categorized based on admission blood glucose (<180 and ≥180 mg/dl, 50 patients in each group). Both groups were compared for clinical outcomes, adverse cardiac events and mortality. We also compared the adverse cardiac outcomes based on HbA1c levels (<6% and ≥6%). Results: Patients with high blood glucose on admission (stress hyperglycemia) had significant increased incidences of severe heart failure (Killip class 3 and 4), arrythmias, cardiogenic shock and mortality (p value = 0.001, 0.004, 0.044, and 0.008 respectively). There was no significant association between adverse cardiac events and HbA1c levels (heart failure 18.8% vs. 25%, p value = 0.609 and mortality 16.7% vs. 17.3%, p value = 0.856). Conclusions: Stress hyperglycemia is significantly associated with adverse clinical outcomes in patients with MI irrespective of previous diabetic history or glycemic control. Clinicians should be vigilant for admission blood glucose while treating MI patients.

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