scholarly journals Relationship between cardiac biomarker concentrations and long-term mortality in subjects with osteoarthritis

PLoS ONE ◽  
2020 ◽  
Vol 15 (12) ◽  
pp. e0242814
Author(s):  
Martin Rehm ◽  
Gisela Büchele ◽  
Raphael Simon Peter ◽  
Rolf Erwin Brenner ◽  
Klaus-Peter Günther ◽  
...  
Keyword(s):  
High Sensitivity ◽  
Cardiac Biomarkers ◽  
Continuous Variables ◽  
Prognostic Information ◽  
Cardiac Biomarker ◽  
Risk Of Mortality ◽  
Increased Risk ◽  
Long Term Mortality

Osteoarthritis (OA) is associated with adverse cardio-metabolic features. N-terminal pro-B-type natriuretic peptide (NT-proBNP) and high-sensitivity troponins T and I (hs-cTnT and hs-cTnI) are well-characterized cardiac markers and provide prognostic information. The objective was to assess the association of cardiac biomarker concentrations with long-term mortality in subjects with OA. In a cohort of 679 OA subjects, undergoing hip or knee replacement during 1995/1996, cardiac biomarkers were measured and subjects were followed over 20 years. During a median follow-up of 18.4 years, 332 (48.9%) subjects died. Median of hs-cTnT, hs-cTnI, and NT-proBNP at baseline was 3.2 ng/L, 3.9 ng/L, and 96.8 ng/L. The top quartile of NT-proBNP was associated with increased risk of mortality (Hazard Ratio (HR) 1.79, 95% confidence interval (CI) 1.17–2.73) after adjustment for covariates including troponins (hs-cTnT HR 1.30 (95% CI 0.90–1.89), hs-cTnI HR 1.32 (95% CI 0.87–2.00) for top category). When biomarker associations were evaluated as continuous variables, only NT-proBNP (HR per log-unit increment 1.34, 95% CI 1.16–1.54) and hs-cTnI (HR 1.38, 95% CI 1.11–1.72) showed robust results. Elevated cardiac biomarker concentrations predicted an increased risk of long-term mortality and strongest for NT-proBNP and hs-cTnI. These results might help to identify subjects at risk and target preventive efforts early.

Magnitude of bacteraemia is a predictor of mortality during 1 year of follow-up

2008 ◽  
Vol 137 (1) ◽  
pp. 94-101 ◽  
Author(s):  
K. O. GRADEL ◽  
M. SØGAARD ◽  
C. DETHLEFSEN ◽  
H. NIELSEN ◽  
H. C. SCHØNHEYDER
Keyword(s):  
Surgical Patients ◽  
Adjusted Risk ◽  
High Magnitude ◽  
Risk Of Mortality ◽  
Increased Risk ◽  
Cox's Regression ◽  
First Time ◽  
Long Term Mortality

SUMMARYWe evaluated magnitude of bacteraemia as a predictor of mortality, comprising all adult patients with a first-time mono-microbial bacteraemia. The number of positive bottles [1 (reference), 2, or 3] in the first positive blood culture (BC) was an index of magnitude of bacteraemia. We used Cox's regression analysis to determine age and comorbidity adjusted risk of mortality at days 0–7, 8–30, and 31–365. Of 6406 patients, 31·1% had BC index 1 (BCI 1), 18·3% BCI 2, and 50·6% BCI 3. BCI 3 patients had increased risk of mortality for days 0–7 (1·30, 95% CI 1·10–1·55) and days 8–30 (1·37, 95% CI 1·12–1·68), but not thereafter. However, in surgical patients mortality increased only beyond day 7 (8–30 days: 2·04, 95% CI 1·25–3·33; 31–365 days: 1·27, 95% CI 0·98–1·65). Thus, high magnitude of bacteraemia predicted mortality during the first month with a shift towards long-term mortality in surgical patients.

Long-term mortality rates and associated risk factors following primary and revision knee arthroplasty

2022 ◽  
Vol 104-B (1) ◽  
pp. 45-52
Author(s):  
Liam Zen Yapp ◽  
Nick D. Clement ◽  
Matthew Moran ◽  
Jon V. Clarke ◽  
A. Hamish R. W. Simpson ◽  
...  
Keyword(s):  
General Population ◽  
Knee Arthroplasty ◽  
Mortality Rates ◽  
Factors Associated ◽  
Revision Knee Arthroplasty ◽  
Risk Of Mortality ◽  
Increased Risk ◽  
Male Sex ◽  
Long Term Mortality

Aims The aim of this study was to determine the long-term mortality rate, and to identify factors associated with this, following primary and revision knee arthroplasty (KA). Methods Data from the Scottish Arthroplasty Project (1998 to 2019) were retrospectively analyzed. Patient mortality data were linked from the National Records of Scotland. Analyses were performed separately for the primary and revised KA cohorts. The standardized mortality ratio (SMR) with 95% confidence intervals (CIs) was calculated for the population at risk. Multivariable Cox proportional hazards were used to identify predictors and estimate relative mortality risks. Results At a median 7.4 years (interquartile range (IQR) 4.0 to 11.6) follow-up, 27.8% of primary (n = 27,474/98,778) and 31.3% of revision (n = 2,611/8,343) KA patients had died. Both primary and revision cohorts had lower mortality rates than the general population (SMR 0.74 (95% CI 0.73 to 0.74); p < 0.001; SMR 0.83 (95% CI 0.80 to 0.86); p < 0.001, respectively), which persisted for 12 and eighteight years after surgery, respectively. Factors associated with increased risk of mortality after primary KA included male sex (hazard ratio (HR) 1.40 (95% CI 1.36 to 1.45)), increasing socioeconomic deprivation (HR 1.43 (95% CI 1.36 to 1.50)), inflammatory polyarthropathy (HR 1.79 (95% CI 1.68 to 1.90)), greater number of comorbidities (HR 1.59 (95% CI 1.51 to 1.68)), and periprosthetic joint infection (PJI) requiring revision (HR 1.92 (95% CI 1.57 to 2.36)) when adjusting for age. Similarly, male sex (HR 1.36 (95% CI 1.24 to 1.49)), increasing socioeconomic deprivation (HR 1.31 (95% CI 1.12 to 1.52)), inflammatory polyarthropathy (HR 1.24 (95% CI 1.12 to 1.37)), greater number of comorbidities (HR 1.64 (95% CI 1.33 to 2.01)), and revision for PJI (HR 1.35 (95% 1.18 to 1.55)) were independently associated with an increased risk of mortality following revision KA when adjusting for age. Conclusion The SMR of patients undergoing primary and revision KA was lower than that of the general population and remained so for several years post-surgery. However, approximately one in four patients undergoing primary and one in three patients undergoing revision KA died within tenten years of surgery. Several patient and surgical factors, including PJI, were associated with the risk of mortality within ten years of primary and revision surgery. Cite this article: Bone Joint J 2022;104-B(1):45–52.

Abstract 2099: Pretransplant Toxoplasma Gondii Seropositivity Amongst Heart Transplant Recipients Is Associated With An Increased Risk Of All-cause And Cardiac Mortality

Circulation ◽  
2007 ◽  
Vol 116 (suppl_16) ◽  
Author(s):  
Satish Arora ◽  
Pål Jenum ◽  
Pål Aukrust ◽  
Halvor Rollag ◽  
Arne Andreassen ◽  
...  
Keyword(s):  
Toxoplasma Gondii ◽  
Heart Transplant ◽  
Acute Cellular Rejection ◽  
Serum Samples ◽  
Regulatory Changes ◽  
Risk Of Mortality ◽  
Increased Risk ◽  
Cellular Rejection

Chronic Toxoplasma gondii (T. gondii ) infection is known to trigger potentially adverse immuno-regulatory changes, but the long-term implication for heart transplant (HTx) recipients has not been assessed previously. Hence, we evaluated the risk of mortality, development of cardiac allograft vasculopathy (CAV) and acute cellular rejection amongst T. gondii seropositive HTx recipients and the four donor/recipient seropairing groups. Methods: Frozen pre-HTx serum samples of 288 recipients and 246 donors were evaluated for T. gondii serostatus using Platelia IgG immunoassay method. All patients had also undergone prospective serostatus evaluation using alternative assays and results determined by the two methods were compared. Follow-up data regarding mortality, CAV development and acute cellular rejection was available for all patients. Results: Overall, 211 (73%) recipients were seronegative and 77 (27%) were seropositive. In total, 82 recipients died, 76 developed CAV and 82 had significant cellular rejection. Recipient seropositivity was associated with a significantly higher risk of all-cause mortality (hazard ratio [HR], 1.9; 95% CI, 1.1–3.4; p= 0.02) and CAV mortality (HR=4.4; 95% CI, 1.3–15.6, p=0.02), but was not associated with earlier CAV development or higher rejection score. Donor/recipient seropairing status was not a risk factor for any endpoint. Conclusions: T. gondii seropositivity amongst HTx recipients is associated with a significantly increased risk of long-term total, and in particular CAV-related, mortality. This may be mediated via immunoregulatory changes triggered by chronic T. gondii infection and needs to be explored further.

scholarly journals Increased mortality in patients with corticosteroid-dependent asthma: a nationwide population-based study

2019 ◽  
Vol 54 (5) ◽  
pp. 1900804 ◽  
Author(s):  
Hyun Lee ◽  
Jiin Ryu ◽  
Eunwoo Nam ◽  
Sung Jun Chung ◽  
Yoomi Yeo ◽  
...  
Keyword(s):  
Baseline Period ◽  
Population Based ◽  
High Dose ◽  
Population Based Study ◽  
Risk Of Mortality ◽  
Increased Risk ◽  
Korean National Health Insurance ◽  
Independent Cohort ◽  
Long Term Mortality

IntroductionChronic systemic corticosteroid (CS) therapy is associated with an increased risk of mortality in patients with many chronic diseases. However, it has not been elucidated whether chronic systemic CS therapy is associated with increased mortality in patients with asthma. The aim of this study was to determine the effects of chronic systemic CS therapy on long-term mortality in adult patients with asthma.MethodsA population-based matched cohort study of males and females aged ≥18 years with asthma was performed using the Korean National Health Insurance Service database from 2005 to 2015. Hazard ratio (HR) with 95% confidence interval for all-cause mortality among patients in the CS-dependent cohort (CS use ≥6 months during baseline period) relative to those in the CS-independent cohort (CS use <6 months during baseline period) was evaluated.ResultsThe baseline cohort included 466 941 patients with asthma, of whom 8334 were CS-dependent and 458 607 were CS-independent. After 1:1 matching, 8334 subjects with CS-independent asthma were identified. The HR of mortality associated with CS-dependent asthma relative to CS-independent asthma was 2.17 (95% CI 2.04–2.31). In patients receiving low-dose CS, the HR was 1.84 (95% CI 1.69–2.00); in patients receiving high-dose CS, the HR was 2.56 (95% CI 2.35–2.80).ConclusionsIn this real-world, clinical practice, observational study, chronic use of systemic CS was associated with increased risk of mortality in patients with asthma, with a significant dose–response relationship between systemic CS use and long-term mortality.

scholarly journals Redefining Cardiac Biomarkers in Predicting Mortality of Inpatients With COVID-19

Hypertension ◽  
2020 ◽  
Vol 76 (4) ◽  
pp. 1104-1112 ◽  
Author(s):  
Juan-Juan Qin ◽  
Xu Cheng ◽  
Feng Zhou ◽  
Fang Lei ◽  
Gauri Akolkar ◽  
...  
Keyword(s):  
Natriuretic Peptide ◽  
Troponin I ◽  
Cox Model ◽  
Cardiac Injury ◽  
High Sensitivity ◽  
Cardiac Biomarkers ◽  
Cardiac Biomarker ◽  
Increased Risk ◽  
Poor Outcomes ◽  
Prognostic Power

The prognostic power of circulating cardiac biomarkers, their utility, and pattern of release in coronavirus disease 2019 (COVID-19) patients have not been clearly defined. In this multicentered retrospective study, we enrolled 3219 patients with diagnosed COVID-19 admitted to 9 hospitals from December 31, 2019 to March 4, 2020, to estimate the associations and prognostic power of circulating cardiac injury markers with the poor outcomes of COVID-19. In the mixed-effects Cox model, after adjusting for age, sex, and comorbidities, the adjusted hazard ratio of 28-day mortality for hs-cTnI (high-sensitivity cardiac troponin I) was 7.12 ([95% CI, 4.60–11.03] P <0.001), (NT-pro)BNP (N-terminal pro-B-type natriuretic peptide or brain natriuretic peptide) was 5.11 ([95% CI, 3.50–7.47] P <0.001), CK (creatine phosphokinase)-MB was 4.86 ([95% CI, 3.33–7.09] P <0.001), MYO (myoglobin) was 4.50 ([95% CI, 3.18–6.36] P <0.001), and CK was 3.56 ([95% CI, 2.53–5.02] P <0.001). The cutoffs of those cardiac biomarkers for effective prognosis of 28-day mortality of COVID-19 were found to be much lower than for regular heart disease at about 19%–50% of the currently recommended thresholds. Patients with elevated cardiac injury markers above the newly established cutoffs were associated with significantly increased risk of COVID-19 death. In conclusion, cardiac biomarker elevations are significantly associated with 28-day death in patients with COVID-19. The prognostic cutoff values of these biomarkers might be much lower than the current reference standards. These findings can assist in better management of COVID-19 patients to improve outcomes. Importantly, the newly established cutoff levels of COVID-19–associated cardiac biomarkers may serve as useful criteria for the future prospective studies and clinical trials.

scholarly journals Risk of Venous Thromboembolism after New Onset Heart Failure

2019 ◽  
Vol 9 (1) ◽  
Author(s):  
Nathaniel R. Smilowitz ◽  
Qi Zhao ◽  
Li Wang ◽  
Sulena Shrestha ◽  
Onur Baser ◽  
...  
Keyword(s):  
Heart Failure ◽  
Venous Thromboembolism ◽  
Cardiovascular Morbidity And Mortality ◽  
Increased Risk ◽  
New Diagnosis ◽  
Over Time ◽  
Long Term Mortality ◽  
New Onset

AbstractNew-onset heart failure (HF) is associated with cardiovascular morbidity and mortality. It is uncertain to what extent HF confers an increased risk of venous thromboembolism (VTE). Adults ≥65 years old hospitalized with a new diagnosis of HF were identified from Medicare claims from 2007–2013. We identified the incidence, predictors and outcomes of VTE in HF. We compared VTE incidence during follow-up after HF hospitalization with a corresponding period 1-year prior to the HF diagnosis. Among 207,535 patients with a new HF diagnosis, the cumulative incidence of VTE was 1.4%, 2.5%, and 10.5% at 30 days, 1 year, and 5 years, respectively. The odds of VTE were greatest immediately after new-onset HF and steadily declined over time (OR 2.2 [95% CI 2.0–2.3], OR 1.5 [1.4–1.7], and OR 1.2 [1.2–1.3] at 0–30 days, 4–6 months, and 7–9 months, respectively). Over 26-month follow-up, patients with HF were at two-fold higher risk of VTE than patients without HF (adjusted HR 2.31 [2.18–2.45]). VTE during follow-up was associated with long-term mortality (adjusted HR 1.60, 95% CI 1.56–1.64). In conclusion, patients with HF are at increased risk of VTE early after a new HF diagnosis. VTE in patients with HF is associated with long-term mortality.

scholarly journals Elevated high-sensitivity troponin T levels at 1-year follow-up are associated with increased long-term mortality after TAVR

2020 ◽  
Author(s):  
Hatim Seoudy ◽  
Moritz Lambers ◽  
Vincent Winkler ◽  
Linnea Dudlik ◽  
Sandra Freitag-Wolf ◽  
...  
Keyword(s):  
Troponin T ◽  
High Sensitivity ◽  
Left Ventricular ◽  
Adverse Outcomes ◽  
Chronic Obstructive ◽  
High Sensitivity Troponin ◽  
High Sensitivity Troponin T ◽  
Long Term Mortality

Abstract Background Elevated pre-procedural high-sensitivity troponin T (hs-TnT) levels predict adverse outcomes in patients with severe aortic stenosis (AS) undergoing transcatheter aortic valve replacement (TAVR). It is unknown whether elevated troponin levels still provide prognostic information during follow-up after successful TAVR. We evaluated the long-term implications of elevated hs-TnT levels found at 1-year post-TAVR. Methods and results The study included 349 patients who underwent TAVR for severe AS from 2010–2019 and for whom 1-year hs-TnT levels were available. Any required percutaneous coronary interventions were performed > 1 week before TAVR. The primary endpoint was survival time starting at 1-year post-TAVR. Optimal hs-TnT cutoff for stratifying risk, identified by ROC analysis, was 39.4 pg/mL. 292 patients had hs-TnT < 39.4 pg/mL (median 18.3 pg/mL) and 57 had hs-TnT ≥ 39.4 pg/mL (median 51.2 pg/mL). The high hs-TnT group had a higher median N-terminal pro-B-type natriuretic peptide (NT-proBNP) level, greater left ventricular (LV) mass, higher prevalence of severe diastolic dysfunction, LV ejection fraction < 35%, severe renal dysfunction, and more men compared with the low hs-TnT group. All-cause mortality during follow-up after TAVR was significantly higher among patients who had hs-TnT ≥ 39.4 pg/mL compared with those who did not (mortality rate at 2 years post-TAVR: 12.3% vs. 4.1%, p = 0.010). Multivariate analysis identified 1-year hs-TnT ≥ 39.4 pg/mL (hazard ratio 2.93, 95% CI 1.91–4.49, p < 0.001), NT-proBNP level > 300 pg/mL, male sex, an eGFR < 60 mL/min/1.73 m2 and chronic obstructive pulmonary disease as independent risk factors for long-term mortality after TAVR. Conclusions Elevated hs-TnT concentrations at 1-year after TAVR were associated with a higher long-term mortality. Graphic abstract

Abstract 1852: The Association Between Perioperative Complications, Intermediate Survival and Use of Aprotinin During Isolated Coronary Bypass Grafting Surgery

Circulation ◽  
2007 ◽  
Vol 116 (suppl_16) ◽  
Author(s):  
Niv Ad ◽  
Alan M Speir ◽  
Michelle Harrison ◽  
Sharon L Hunt ◽  
Scott D Barnett
Keyword(s):  
Renal Failure ◽  
Adverse Outcome ◽  
Perioperative Complications ◽  
Coronary Bypass ◽  
Coronary Bypass Grafting ◽  
Risk Of Mortality ◽  
Increased Risk ◽  
Mortality Estimates ◽  
Long Term Mortality

Introduction: Aprotinin during CABG has been linked to increased rates of perioperative complications and increased long-term mortality. We report our results for the association of CABG, aprotinin use and intermediate survival. Methods: Subjects were 1,679 isolated CABG, on-pump, cases with no prior hx of renal failure or dialysis between 2001 and 2002. Aprotinin pts were additionally propensity matched to non-aprotinin pts to control for pt acuity. Increased EuroSCORE (E) indicates increased pt acuity. Results: Aprotinin pts (n=817) presented as older (63.7 vs. 61.2, p=0.05), increased E (6.5 vs. 4.1, p=0.05), and urgent operative status (61.7% vs. 41.6%, p=0.05). This group experienced greater rates of perioperative prolonged ventilation (8.7%% vs. 4.8%, p=0.01), acute renal failure (4.3% vs. 2.0%, p=0.01), 30d mortality (2.2% vs. 1.0%, p=0.06) and signif. decreased unmatched 5-year survival (86.1%, vs. 92.8%, p=0.001). Aprotinin use was not signif. assoc. with increased intermediate mortality (HR: 1.26; 95% CI: 0.66–2.41) but cases with high E (6+) were (HR: 5.47; 95% CI: 2.98–10.08). Moderate E was not signif. assoc. with mortality (HR: 1.75; 95% CI: 0.91–3.35) nor was any aprotinin-E interaction term (HR: 1.00; 95% CI: 0.93–1.08). After matching, controls were signif. less at risk of mortality at 5 years, (91.3% vs. 88.1%, p=0.05; Figure 1 ). Conclusions: Our results suggest that pts with aprotinin experienced higher rates of perioperative complications; however, the pts in this group were generally at higher risk for adverse outcome. Aprotinin use may convey an increased risk of intermediate mortality, but after matching, mortality estimates are greatly reduced.

scholarly journals Epilepsy-associated long-term mortality after aneurysmal subarachnoid hemorrhage

Neurology ◽  
2017 ◽  
Vol 89 (3) ◽  
pp. 263-268 ◽  
Author(s):  
Jukka Huttunen ◽  
Antti Lindgren ◽  
Mitja I. Kurki ◽  
Terhi Huttunen ◽  
Juhana Frösen ◽  
...  
Keyword(s):  
Subarachnoid Hemorrhage ◽  
Causes Of Death ◽  
University Hospital ◽  
Study Cohort ◽  
Catchment Population ◽  
Risk Of Death ◽  
Increased Risk ◽  
Long Term Mortality

Objective:To elucidate the epilepsy-associated causes of death and subsequent excess long-term mortality among 12-month survivors of subarachnoid hemorrhage from saccular intracranial aneurysm (SIA-SAH).Methods:The Kuopio SIA Database (kuopioneurosurgery.fi) includes all SIA-SAH patients admitted to the Kuopio University Hospital from its defined catchment population in Eastern Finland. The study cohort consists of 779 patients, admitted from 1995 to 2007, who were alive at 12 months after SIA-SAH. Their use of reimbursable antiepileptic drugs and the causes of death (ICD-10) were fused from the Finnish national registries from 1994 to 2014.Results:The 779 12-month survivors were followed up until death (n = 197) or December 31, 2014, a median of 12.0 years after SIA-SAH. Epilepsy had been diagnosed in 121 (15%) patients after SIA-SAH, and 34/121 (28%) had died at the end of follow-up, with epilepsy as the immediate cause of death in 7/34 (21%). In the 779 patients alive at 12 months after SIA-SAH, epilepsy was an independent risk factor for mortality (hazard ratio 1.8, 95% confidence interval 1.1–3.0).Conclusions:Comorbid epilepsy in 12-month survivors of SIA-SAH is associated with increased risk of death in long-term follow-up. Survivors of SIA-SAH require long-term dedicated follow-up, including identification and effective treatment of comorbid epilepsy to prevent avoidable deaths.

Abstract 16958: Comparison of Clinical and Hemodynamic Outcomes Between Redo Surgical Aortic Valve Replacement versus Transcatheter Valve in Valve in Patient With Failed Aortic Bioprostheses

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Sebastien Hecht ◽  
Jeremy Bernard ◽  
Lionel Tastet ◽  
nancy cote ◽  
Erwan Salaun ◽  
...  
Keyword(s):  
Lower Risk ◽  
Surgical Aortic Valve Replacement ◽  
Increased Risk ◽  
Long Term Follow Up ◽  
Valve In Valve ◽  
Transcatheter Valve ◽  
Valve Implantation ◽  
Long Term Mortality

Introduction: Transcatheter valve-in-valve implantation (ViV) has emerged as an alternative to redo surgery (REDO) for the treatment of failed surgical aortic bioprostheses. However, there are few studies comparing clinical and hemodynamic outcomes between REDO and ViV in both the short- and long- term follow-up. Objective: The aim of this study was to compare hemodynamic and clinical outcomes between REDO and ViV. Methods: A total of 184 patients who underwent REDO or ViV at our institution between 2003 and 2017 were included in this study. Clinical and transthoracic echocardiography (TTE) data were collected for each patient. TTE was performed prior and after the reintervention and were retrospectively analyzed in an echocardiography core laboratory. An inverse propensity treatment weighting (IPTW) was used to compare outcomes between groups. Results: 104 patients underwent REDO and 80 underwent ViV. Prevalence of suboptimal valve hemodynamics (mean gradient ≥ 20 mmHg and/or ≥ moderate aortic regurgitation) following reintervention was higher in ViV group (29.8% vs. 61.3%, p<0.001), the rate of novel permanent pacemaker tended to be higher with REDO (10.6% vs. 3.8%, p=0.08). During a median follow-up of 5.0 (3.7-7.5) years, 60 patients died. There was a trend toward higher rate of 30-day mortality in the REDO vs. ViV group (8.6% vs. 2.5%, OR [95% CI]: 3.70[0.77-17.6], p=0.10) and a trend toward lower risk of long-term mortality in REDO (HR [95% CI]: 0.61[0.33-1.14], p=0.12). In multivariate cox proportional analysis adjusted for age, sex, EuroSCORE 2, ViV was significantly associated with increased risk of long-term mortality (HR [95% CI]: 2.28[1.25-4.15], p=0.03). Results were confirmed in IPTW analyses (30-day mortality in REDO vs. ViV: 3.39[3.25-3.53], p<0.001; long-term mortality: 0.70[0.69-0.71], p<0.001). Conclusions: ViV was associated with lower risk of 30-day but higher risk of long-term mortality compared to REDO.

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