Coronary-Artery Bypass Grafting

Raza, Sajjad; Eh, Blackstone; Jf, Sabik

doi:10.1056/nejmc1608042

Cited by 38 publications

(11 citation statements)

References 9 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In women undergoing CABG who were older and had lower ejection fraction and more extensive coronary disease, the beneficial effect of CABG over PCI has been gradually manifested during the late follow‐up period, which was not evident in the early period. 34 Although the reasons for some discordant observations between SYNTAXES and this study are not fully understood, differences in genetic and hormonal factors, and the sizes of coronary arteries, as well as the differences in patient profiles, and procedural and operative characteristics, have been mentioned as possible explanations. 5 , 35 In addition, a recent meta‐analysis suggested the presence of the heterogeneous sex–treatment interaction in trials across Asian and Western regions.…”

Section: Discussionmentioning

confidence: 61%

Time‐Dependent Impact of Sex on the Long‐Term Outcomes After Left Main Revascularization

Yoon

Ahn

Lee

et al. 2022

JAHA

View full text Add to dashboard Cite

Background There are still limited data about the differential effect of sex on long‐term outcomes after percutaneous coronary intervention (PCI) or coronary artery bypass grafting (CABG) for left main coronary artery disease. This extended follow‐up study of the MAIN‐COMPARE (Ten‐Year Outcomes of Stents Versus Coronary‐Artery Bypass Grafting for Left Main Coronary Artery Disease) registry evaluated clinical outcomes beyond 10 years. Methods and Results Of 2240 patients with unprotected left main coronary artery disease (PCI=1102 and CABG=1138), all‐cause mortality, the composite of death, Q‐wave myocardial infarction, or stroke, and target vessel revascularization were separately evaluated in both sexes. Of 2240 patients, 631 (28.2%) were women and 1609 (71.8%) were men. Women had lower 10‐year incidences of death and serious composite outcomes than men. The adjusted 10‐year risks of adverse outcomes were similar in men. However, the adjusted 10‐year risks were different according to a prespecified period in women. In the short‐term (0–1 year) period, PCI had a significantly lower risk for serious composite outcomes (adjusted hazard ratio [HR], 0.41; 95% CI, 0.19–0.91; P =0.03) compared with CABG. The adjusted risks for death and serious composite outcomes were significantly higher after PCI than after CABG, during the midterm (1–5 years) period (death; adjusted HR, 3.99; 95% CI, 2.01–7.92; P <0.001 and composite outcome; adjusted HR, 2.93; 95% CI, 1.59–5.39; P =0.001). Beyond 5 years, adjusted risks were similar after PCI and CABG in women. Conclusions In this 10‐year extended follow‐up study of patients undergoing left main coronary artery revascularization, we observed a time‐dependent impact of sex on the long‐term outcomes after PCI and CABG, especially in women, with significant interactions. However, these results warrant confirmation on larger series of studies. Registration URl: https://www.clinicaltrials.gov ; Unique identifier: NCT02791412.

show abstract

Section: Discussionmentioning

confidence: 61%

Time‐Dependent Impact of Sex on the Long‐Term Outcomes After Left Main Revascularization

Yoon

Ahn

Lee

et al. 2022

JAHA

View full text Add to dashboard Cite

show abstract

“…Patients meeting the inclusion and exclusion criteria were enrolled from April 2018 to December 2021. The inclusion criteria were as follows: (1) CAD patients with 3VD confirmed by coronary angiography, waiting elective on-pump CABG; (2) LVEF >45% (Simpson’s method) ( 6 , 18 ); and (3) sinus rhythm. The exclusion criteria were as follows: (1) the presence of chronic or acute pulmonary disease; (2) morbid obesity (body mass index >40 kg/m 2 ); (3) moderate to severe valvular heart disease including stenosis, prolapse, and regurgitation; (4) cardiomyopathy; (5) previous pacemaker implantation; (6) prosthetic valve; (7) the presence of chronic or acute kidney disease; and (8) poor echocardiographic image quality.…”

Section: Methodsmentioning

confidence: 99%

Section: Study Populationmentioning

confidence: 99%

“…(3) moderate to severe valvular heart disease including stenosis, prolapse, and regurgitation; (4) cardiomyopathy; (5) previous pacemaker implantation; (6) prosthetic valve; (7) the presence of chronic or acute kidney disease; and (8) poor echocardiographic image quality. This study was registered at clinicaltrials.gov (NCT03235323) and was performed in accordance with the ethical standards of the Institutional Ethics Committee.…”

Section: Study Populationmentioning

confidence: 99%

“…Nevertheless, patients undergoing CABG remain at a high risk of adverse cardiovascular outcomes. In particularly, the highest risk exists during and shortly after surgery ( 6 ). Shroyer et al ( 7 ) reported relatively high 30-day mortality and composite morbidity rates for CABG procedures (3.05 and 13.40%, respectively).…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Predictive value of left ventricular dyssynchrony for short-term outcomes in three-vessel disease patients undergoing coronary artery bypass grafting with preserved or mildly reduced left ventricular ejection fraction

Liu

Fan

et al. 2022

Front. Cardiovasc. Med.

View full text Add to dashboard Cite

Background and objectiveCoronary artery bypass grafting (CABG) is the reference standard intervention in coronary artery disease (CAD) patients with three-vessel disease (3VD). We aimed to evaluate the predictive value of left ventricular (LV) dyssynchrony for short-term adverse outcomes in patients with 3VD undergoing CABG with preserved or mildly reduced LV ejection fraction (LVEF).Materials and methodsThis study involved ninety-five 3VD patients with preserved or mildly reduced LVEF undergoing scheduled on-pump CABG. The pre-operative diameters and volumes of LV and LVEF were obtained by two-dimensional echocardiography. LV dyssynchrony parameters were acquired by real-time three-dimensional echocardiography (RT-3DE) and analyzed by HeartModel quantification software. And the perfusion index of LV was obtained by contrast echocardiography. The clinical endpoints of short-term adverse outcomes comprised 30-day mortality and/or composite outcomes of postoperative complications. Univariate and multivariate logistic regression analyses were used to identify risk factors for the occurrence of post-CABG short-term adverse outcomes.ResultsShort-term adverse outcomes occurred in 12 (12.6%) patients. These patients had higher LV dyssynchrony parameters obtained through RT-3DE. The standard deviation (SD) of the time to minimum systolic volume (Tmsv) corrected by heart rate over 16 segments (Tmsv16-SD%) [odds ratio (OR), 1.362; 95% confidence interval (CI) (1.090–1.702); P = 0.006], one of the LV dyssynchrony parameters, was independently associated with short-term adverse outcomes. Patients with poor synchronization tended to spend more time in the intensive care unit (ICU) and hospital after surgery.ConclusionPre-operative LV dyssynchrony parameter Tmsv16-SD% obtained through RT-3DE could be a useful additional predictor of postoperative short-term adverse outcomes in 3VD patients with preserved or mildly reduced LVEF undergoing CABG.

show abstract

The risk of dementia after coronary artery bypass grafting in relation to age and sex

Giang

Jeppsson

Karlsson

et al. 2021

Alzheimer's & Dementia

View full text Add to dashboard Cite

Introduction:We examined the long-term risk of dementia after coronary artery bypass grafting (CABG) in relation to age and sex.Methods: All CABG patients in Sweden 1992Sweden -2015, and matched controls (n = 222,396) were included in a population-based study. Adjusted hazard ratios (aHR) for all-cause dementia, vascular dementia, and Alzheimer's disease were calculated.Results: There was no difference in the risk for all-cause dementia between CABG patients and control subjects (aHR 0.98 [95% confidence interval 0.95 to 1.02]). CABG patients <65 years and 65 to 74 years had higher risk and 1.08 [1.02-1.13], respectively), and patients ≥75 years had lower risk (aHR 0.76 [0.71-0.81]). The highest risk was observed in women <65 years (aHR 1.64 [1.31-2.05]).Discussion: Overall, the long-term risk for all-cause dementia does not differ between CABG patients and the general population. Younger patients have a higher risk, while older patients have a lower risk, compared to controls.

show abstract

Coronary-Artery Bypass Grafting

Cited by 38 publications

References 9 publications

Time‐Dependent Impact of Sex on the Long‐Term Outcomes After Left Main Revascularization

Time‐Dependent Impact of Sex on the Long‐Term Outcomes After Left Main Revascularization

Predictive value of left ventricular dyssynchrony for short-term outcomes in three-vessel disease patients undergoing coronary artery bypass grafting with preserved or mildly reduced left ventricular ejection fraction

The risk of dementia after coronary artery bypass grafting in relation to age and sex

Contact Info

Product

Resources

About