scholarly journals Predictors of cardiovascular events in patients with chronic heart disease after surgical myocardial revascularization (according to the data of a long-term observation)

2010 ◽  
Vol 1 (1) ◽  
pp. 75-79
Author(s):  
S. V Shalayev ◽  
L. A Arutyunyan
Keyword(s):  
Myocardial Infarction ◽  
Mechanical Ventilation ◽  
Heart Disease ◽  
Coronary Artery ◽  
Cardiovascular Events ◽  
Artery Bypass ◽  
Myocardial Revascularization ◽  
Bypass Grafting ◽  
Chronic Heart Disease

Aim. To elucidate independent predictors of fatal and nonfatal cardiovascular events in patients with chronic heart disease (CHD) after surgical myocardial revascularization during a long-term prospective observation. Subjects and methods. The study enrolled 120 patients with CHD who had undergone coronary artery bypass grafting with extracorporeal circulation. Further 2-5-year follow-ups recorded deaths from cardiac causes, including sudden deaths, as well as the incidence of nonfatal cardiovascular events (myocardial infarction, stroke). Results. The mean follow-up time was 36±5 months. During the follow-ups, there were 12 deaths: 1 and 8 deaths from pneumonia and myocardial infarction, respectively; 3 patients died suddenly. Out of the nonfatal events, myocardial infarction and stroke were recorded in 7 and 2 cases, respectively. Stepwise regression analysis showed that the independent predictors of fatal cardiac events were as follows: 1) an ejection fraction of less than 40% (relative risk 5.7 with deviations within 95% confidence interval, 1,2–10,7); 2) age of 70 years or older (4,9; 1,4–8,4); 3) diabetes mellitus (2,3; 1,1–3,7); 4) left ventricular aneurysm (2,1; 1,04–3,8); 5) mechanical ventilation for more than 24 hours (2,0; 1,2–2,9); 6) chronic obstructive pulmonary disease (1,9; 1,1–3,1). The independent predictors of all cases of both fatal and nonfatal cardiovascular events were: 1) age of 70 years or older (4,1; 1,2–8,1); 2) an ejection fraction of less than 40% (3,7; 1,1–6,5); 3) endarterectomy during coronary artery bypass grafting (2,9; 1,1–5,4); 4) mechanical ventilation for more than 100 minutes (2,2; 1,2–3,9); damage to the brachiocephalic artery area (2,1; 1,1–6,4), prior stroke (1,8; 1,1–3,8). Conclusion. The conducted study indicated the implication of both the poor traditional predictors of CHD and comorbidity, as well as the specific features of surgical intervention and anesthetic maintenance in the development of further fatal and nonfatal cardiovascular events in patients with CHD after surgical myocardial revascularization.

Abstract 14484: The Association of Pre-operative Glycemic Control With Long-term Survival in Diabetic Patients After Coronary Artery Bypass Grafting

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Muhammad Sheikh ◽  
Salil V Deo ◽  
Varun Sundaram ◽  
Brigid Wilson ◽  
Jayakumar Sahadevan ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Coronary Artery ◽  
Artery Bypass ◽  
Diabetic Patients ◽  
Bypass Grafting ◽  
Term Survival ◽  
Long Term Survival ◽  
Group Iii ◽  
Insulin Dependence

Introduction: We analyzed the national Veteran Affairs (VA) data to evaluate the association of preoperative glycated Hemoglobin (HbA1c) and long-term outcome after isolated coronary artery bypass grafting (CABG). Methods: Between January 2007 - December 2014, Veterans with diabetes mellitus (DM) that underwent isolated CABG were divided on into three groups (I: HbA1c < 8%, II: HbA1c 8 - 10% and III: HbA1c > 10%). Demographic and clinical differences between groups were evaluated with the t-test or chi-square test. The relationship of preoperative HbA1c and long-term survival was evaluated with a multivariable proportional hazards model; restricted cubic splines were used to model non-linear effects. The cumulative incidence of secondary end-points (myocardial infarction, urgent revascularization) for each group was modeled as a competing-risk analysis. Results: Overall, 3,210 patients (mean age 64.6 years, male 98.8%; insulin dependent - 53%) with DM underwent isolated CABG. Group III patients were younger (61 vs 65 years in group I). Median HbA1c levels were similar between races (white - 7.3% and blacks - 7.35%). Insulin dependence was higher in group III (79.3%) vs groups I (43.5%) and II (69.9%). In groups I,II and III, 5 and 10 year survival was 76.2%, 74.4%, 75.4% and 38.9%, 36.9% and 30.2% respectively. HbA1c was observed to have a J-shaped association with mortality with values < 6% and > 9% at higher risk of death. Left ventricular systolic dysfunction [HR 1.5 (1.3 - 1.7)], prior myocardial infarction [HR 1.3 (1.2 - 1.5)] and insulin dependence [HR 1.4 (1.2 - 1.5)] were also associated with lower survival. Myocardial infarction was observed in 9.8% , 13.4% and 12.8% patients in groups I, II and III respectively. Conclusions: Pre-operative HbA1c impacts long-term survival among diabetic patients undergoing CABG. We observed a J-shaped relationship between HbA1c and survival with values < 6% and > 9% associated with increased mortality.

scholarly journals Calcification markers and long-term outcomes of coronary artery bypass grafting

2021 ◽  
Vol 26 (8) ◽  
pp. 4450
Author(s):  
E. M. Stakhneva ◽  
E. V. Kashtanova ◽  
A. V. Kurguzov ◽  
N. A. Maslatsov ◽  
Ya. V. Polonskaya ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Coronary Artery Bypass Grafting ◽  
Coronary Artery Bypass ◽  
Coronary Atherosclerosis ◽  
Artery Bypass ◽  
Myocardial Revascularization ◽  
Bypass Grafting ◽  
Long Term Outcomes ◽  
Artery Bypass Grafting

Aim. To assess the long-term outcomes of coronary artery bypass grafting (CABG) and their association with calcification biomarkers.Material and methods. The study included 129 men (mean age, 61,5±7,5 years) with coronary atherosclerosis who were admitted for CABG surgery. Patients were divided into 2 groups: with favorable and unfavorable (death, myocardial infarction, stroke, surgery) 5-year prognosis after surgery. Before the surgery, the blood concentrations of calcification biomarkers (osteoprotegerin, osteopontin, osteonectin and osteocalcin) were determined in all patients.Results. Long-term outcomes of myocardial revascularization were studied in 92 patients (71%). An unfavorable long-term 5-year period was identified in 28 men (30,4%). In men with an unfavorable 5-year prognosis, the blood osteocalcin level before CABG was 1,2 times higher than in men with a favorable one. Multivariate linear regression showed that the risk of a 5-year unfavorable prognosis for coronary atherosclerosis after myocardial revascularization was associated with the blood osteocalcin concentration, determined before CABG (B=0,018, R2=0,285, p=0,008).Conclusion. The data obtained indicate the relevance of continuing studies on osteocalcin, including with respect to its contribution to coronary atherosclerosis and calcification.

scholarly journals Coronary Artery Bypass Grafting in Patients 50 Years or Younger

Circulation ◽  
2015 ◽  
Vol 131 (20) ◽  
pp. 1748-1754 ◽  
Author(s):  
Magnus Dalén ◽  
Torbjörn Ivert ◽  
Martin J. Holzmann ◽  
Ulrik Sartipy
Keyword(s):  
Risk Factors ◽  
Young Adults ◽  
Coronary Artery ◽  
Coronary Artery Bypass Grafting ◽  
Coronary Artery Bypass ◽  
Cardiovascular Events ◽  
Artery Bypass ◽  
Bypass Grafting ◽  
Term Survival

Background— There are limited data regarding long-term results after coronary artery bypass grafting (CABG) in young adults. We performed a nationwide population-based cohort study to analyze long-term survival, major adverse cardiovascular events, and factors associated with elevated risk in young adults undergoing CABG. Methods and Results— We included all adult patients ≤50 years of age who underwent primary isolated CABG in Sweden between 1997 and 2013 from the Swedish Web System for Enhancement and Development of Evidence-Based Care in Heart Disease Evaluated According to Recommended Therapies (SWEDEHEART) register. Patient data were linked from national Swedish health data registers to create a study database. We identified 4086 young adults with a mean age of 46 years and 18% women. During a median follow-up time of 10.9 years (interquartile range, 6.4–14.1) 490 (12%) patients died. Survival at 5, 10, and 15 years was 96% (95% CI, 95–96), 90% (95% CI, 89–91), and 82% (95%CI, 80–83), respectively, which was significantly better in comparison with patients aged 51 to 70 years and >70 years who underwent CABG during the same period. The cumulative incidence of death or a major adverse cardiovascular event during 17 years after CABG was mainly driven by myocardial infarction or the need for repeat revascularization. The most important risk factors for all-cause mortality were chronic kidney disease, reduced left ventricular ejection fraction, peripheral vascular disease, or chronic obstructive pulmonary disease. Conclusions— Long-term survival and freedom from major cardiovascular events after CABG was better in young adults than in older patients. Factors significantly associated with an elevated long-term risk of death or adverse outcome were similar to well-known risk factors for older age groups following CABG. Clinical Trial Registration— URL: http://www.clinicaltrials.gov . Unique identifier: NCT02276950.

scholarly journals Long-Term Outcome of a Residual Scar From Myocardial Infarction After Coronary Artery Bypass Grafting

2002 ◽  
Vol 66 (5) ◽  
pp. 445-445 ◽  
Author(s):  
Itaru Adachi ◽  
Hiroaki Akagi ◽  
Hiroaki Shimomura ◽  
Tomomi Nakamura ◽  
Sadae Miyazaki ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Coronary Artery ◽  
Coronary Artery Bypass Grafting ◽  
Coronary Artery Bypass ◽  
Artery Bypass ◽  
Bypass Grafting ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Artery Bypass Grafting

scholarly journals Influence of incomplete revascularisation on the outcomes of coronary artery bypass grafting in patients with ischaemic heart disease

2021 ◽  
Vol 25 (1) ◽  
pp. 74
Author(s):  
A. N. Semchenko ◽  
I. V. Zaicev ◽  
A. M. Schevchenko ◽  
A. V. Semchenko
Keyword(s):  
Coronary Artery ◽  
Coronary Artery Bypass Grafting ◽  
Coronary Artery Bypass ◽  
Cardiovascular Events ◽  
Bypass Surgery ◽  
Artery Bypass ◽  
Long Term Results ◽  
Bypass Grafting ◽  
Artery Bypass Grafting

<p><strong>Background.</strong> At the present time there is no agreement regarding effect of revascularisation volume on long-term results of coronary artery bypass grafting. According to some reports, incomplete revascularisation, compared with complete revascularisation, affects survival and increases the frequency of adverse cardiovascular events. Other researchers do not find such differences.</p><p><strong>Aim.</strong> This study aimed to assess the influence of incomplete revascularisation on the long-term results of coronary bypass surgery and to determine its predictors.</p><p><strong>Methods.</strong> A total of 243 patients with coronary artery disease who underwent microscope-assisted coronary artery bypass surgery were categorised into two groups. Group I included those with complete revascularisation (n = 152), while group II included those with incomplete revascularisation (n = 91). When assigning patients to groups, the volume of achieved myocardial revascularisation was determined according to the patency of grafts. The groups were compared by the late survival and by the frequency of major cardiovascular events. Logistic regression was used to analyse predictors of incomplete revascularisation.</p><p><strong>Results.</strong> The median of follow-up (interquartile range) was 802 days (426–1487 days). Survival in group 1 at 1, 3 and 5 years after surgery was 98%, 98% and 89%, respectively, while in group 2, it was 90%, 86%, and 86%, respectively (p = 0.024). Freedom from major cardiovascular events (death, myocardial infarction, repeated revascularisation, stroke) in group 1 after 1, 3 and 5 years was 91%, 89% and 77%, respectively, and in group 2, it was 78%, 68% and 68%, respectively (p = 0.005). It was revealed that diabetes mellitus (odds ratio [OR] = 1.45, 95% confidence interval [CI] = 1.01–2.09), arteriosclerosis of arteries of two or more localisations (OR = 1.63, CI = 1.15–2.31), number of lesions in circumflex artery system (OR = 2.48, CI = 1.86–3.31), number of lesions in anterior descending artery system (OR = 1.61, CI = 1.14–2.28) and the diameter of the target coronary artery is less than 1.5 mm (OR = 1.3, CI = 1.22–2.38) are independent predictors of incomplete myocardial revascularisation during coronary artery bypass grafting. Male gender (OR = 0.61, CI = 0.41–0.91) and increased body mass index were associated with a reduced risk of incomplete revascularisation (OR = 0.96, CI = 0.93–0.99).</p><p><strong>Conclusion.</strong> Incomplete revascularisation worsens the prognosis after coronary bypass surgery, and is accompanied by an increase in the frequency of adverse cardiovascular events and a decrease in long-term survival. The risk of incomplete revascularisation increases in patients with diabetes mellitus, common manifestations of atherosclerosis, number of lesions in the left coronary system, as well as with a small diameter of the target coronary arteries. Male gender and increased body mass index were associated with a reduced risk of incomplete revascularisation.</p><p>Received 15 June 2020. Revised 23 July 2020. Accepted 24 July 2020.</p><p><strong>Funding:</strong> The study did not have sponsorship.</p><p><strong>Conflict of interest:</strong> Authors declare no conflict of interest.</p>

Sign in / Sign up

Export Citation Format

Share Document