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- Brandrup-Wognsen, Gunnar, 1958, et al.
(författare)
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Mortality during the two years after coronary artery bypass grafting in relation to perioperative factors and urgency of operation.
- 1995
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Ingår i: European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery. - : Elsevier BV. - 1010-7940 .- 1873-734X. ; 9:12, s. 685-91
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Tidskriftsartikel (refereegranskat)abstract
- The purpose of this study was to describe mortality during the 2-year-period after coronary artery bypass surgery (CABG) in relation to perioperative risk factors and urgency of operation. All the patients in western Sweden were included in whom CABG was performed between June 1988 and June 1991, without concomitant procedures or re-operations. The study was prospective in design. In all, 2000 patients were operated upon and 186 (9.3%) of the operations were acute. There was a significant relationship between the urgency of the operation and mortality. Early mortality was 2.4% in elective operations and 5.4-62.5% in urgent to emergency operations. The 30-day to 2-year mortality was 4.2%. The perioperative risk indicators independently associated with early mortality were neurologic complications, serum-aspartate aminotransferase (S-ASAT) more than 2.0 microkat/l, urgency of operation, the use of circulatory assist devices, re-operation and ventilator time more than 24 h. The risk indicators for mortality after 30 days were pneumothorax, longer intensive care unit (ICU) time, the use of inotropic drugs and neurologic complications. In conclusion, the multivariate analysis reveals the urgency of the operation as a predictor of early mortality after CABG, but no significant association with mortality was found after 30 days. When excluding death within 30 days, three additional independent predictors of mortality were identified.
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- Brandrup-Wognsen, Gunnar, 1958, et al.
(författare)
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Preoperative risk indicators of death at an early and late stage after coronary artery bypass grafting.
- 1995
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Ingår i: The Thoracic and cardiovascular surgeon. - : Georg Thieme Verlag KG. - 0171-6425 .- 1439-1902. ; 43:2, s. 77-82
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Tidskriftsartikel (refereegranskat)abstract
- The aim of the study was to describe mortality during a period of two years after coronary artery bypass surgery (CABG) in relation to preoperative risk factors. Included were all the patients in western Sweden in whom CABG was performed between June 1988 and June 1991, without concomitant procedures or re-operations. The study was prospective in design. In all, 2000 patients with a median age of 64 years were operated upon. Early (within 30 days) mortality was 3.0% and late (30-day-2-year) mortality was 4.2%. Total two-year mortality was 7.1%. For patients undergoing coronary artery bypass grafting, the factors found to be independently predictive of early mortality were female sex, renal dysfunction (creatine clearance < 60ml/min), left main stenosis, number of diseased vessels, previous myocardial infarction, and functional class. We found that a history of congestive heart failure, a history of cerebrovascular disease, diabetes mellitus, renal dysfunction and intermittent claudication were independent risk factors for late mortality. In conclusion, with the exception of renal dysfunction, preoperative risk factors for death within 30 days after CABG differ from risk factors for death between 30 days and two years after CABG.
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- Brilakis, Emmanouil S., et al.
(författare)
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Effect of ticagrelor on the outcomes of patients with prior coronary artery bypass graft surgery : Insights from the PLATelet inhibition and patient outcomes (PLATO) trial
- 2013
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Ingår i: American Heart Journal. - : Elsevier BV. - 0002-8703 .- 1097-6744. ; 166:3, s. 474-480
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Tidskriftsartikel (refereegranskat)abstract
- Background Patients with prior coronary artery bypass graft surgery (CABG) who present with an acute coronary syndrome have a high risk for recurrent events. Whether intensive antiplatelet therapy with ticagrelor might be beneficial compared with clopidogrel is unknown. In this substudy of the PLATO trial, we studied the effects of randomized treatment dependent on history of CABG. Methods Patients participating in PLATO were classified according to whether they had undergone prior CABG. The trial's primary and secondary end points were compared using Cox proportional hazards regression. Results Of the 18,613 study patients, 1,133 (6.1%) had prior CABG. Prior-CABG patients had more high-risk characteristics at study entry and a 2-fold increase in clinical events during follow-up, but less major bleeding. The primary end point (composite of cardiovascular death, myocardial infarction, and stroke) was reduced to a similar extent by ticagrelor among patients with (19.6% vs 21.4%; adjusted hazard ratio [HR], 0.91 [0.67, 1.24]) and without (9.2% vs 11.0%; adjusted HR, 0.86 [0.77, 0.96]; P-interaction = .73) prior CABG. Major bleeding was similar with ticagrelor versus clopidogrel among patients with (8.1% vs 8.7%; adjusted HR, 0.89 [0.55, 1.47]) and without (11.8% vs 11.4%; HR, 1.08 [0.98, 1.20]; P-interaction =.46) prior CABG. Conclusions Prior-CABG patients presenting with acute coronary syndrome are a high-risk cohort for death and recurrent cardiovascular events but have a lower risk for major bleeding. Similar to the results in no-prior-CABG patients, ticagrelor was associated with a reduction in ischemic events without an increase in major bleeding.
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- Herlitz, Johan, 1949, et al.
(författare)
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Cause of death during 13 years after coronary artery bypass grafting with emphasis on cardiac death
- 2004
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Ingår i: Scand Cardiovasc J. - : Informa UK Limited. - 1401-7431 .- 1651-2006. ; 38:5, s. 283-6
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: To describe the cause of death in the long term after coronary artery bypass grafting (CABG) with particular emphasis on cardiac death. PATIENTS AND SETTING: All the patients in western Sweden without simultaneous valve surgery and without previous CABG who underwent CABG in 1988-1991 in Goteborg, Sweden. DESIGN: Prospective, observational study for 10.6-13.6 years (i.e. until the end of 2001). Various factors contributing to death were described, with the emphasis on cardiac death. RESULTS: In all, 2000 patients were included in the survey. The all-cause mortality rate was 39%. Fifty-eight per cent of all deaths were judged as cardiac deaths. The most frequent cause of death was heart failure (65% among patients who died within 30 days after CABG and 36% among those who died >30 days after CABG). The second most common cause of death was myocardial infarction (56 and 29%, respectively), followed by cancer (0 and 24%, respectively), stroke (21 and 18%, respectively) and infection (8 and 11%, respectively). CONCLUSION: The factors most commonly contributing to death in the long term after CABG were, in order of frequency, heart failure, myocardial infarction, cancer, stroke and infection.
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- Herlitz, Johan, 1949, et al.
(författare)
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Death, mode of death, morbidity, and rehospitalization after coronary artery bypass grafting in relation to occurrence of and time since a previous myocardial infarction.
- 1997
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Ingår i: The Thoracic and cardiovascular surgeon. - : Georg Thieme Verlag KG. - 0171-6425 .- 1439-1902. ; 45:3, s. 109-13
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Tidskriftsartikel (refereegranskat)abstract
- To describe the prognosis during 2 years after coronary artery bypass grafting (CABG) in relation to occurrence of and time since a previous acute myocardial infarction (AMI), data of all patients in western Sweden who underwent CABG without simultaneous valve surgery in the period June 1988-June 1991 were evaluated. In all, 2120 patients were included in the analyses. Of these, 1296 (61%) had a history of AMI and 127 (6%) had suffered an AMI within the last month before CABG. Mortality during the first 30 days after CABG was for patients with no previous AMI, previous AMI > 30 days prior to CABG, and previous AMI < or = 30 days prior to CABG 2.4%, 4.1%, and 5.5%, respectively (p < 0.05). The corresponding figures for the period between 30 days and 2 years after CABG were 3.6%, 4.4%, and 3.4% respectively (NS). In a multivariate analysis among patients with a previous AMI, a recent infarction (< or = 30 days prior to CABG) did not turn out as an independent predictor of death during 2 years of follow-up. A history of AMI was associated with increased mortality during the first 30 days but not thereafter, but recent AMI was not an independent predictor of total 2-year mortality.
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