ACC/AHA 2004 Guideline Update for Coronary Artery Bypass Graft Surgery: Summary Article

Eagle, Kim A.; Guyton, Robert A.; Davidoff, Ravin; Edwards, Fred H.; Ewy, Gordon A.; Gardner, Timothy J.; Hart, James; Herrmann, Howard C.; Hillis, L. David; Hutter, Adolph M.; Lytle, Bruce W.; Marlow, Robert A.; Nugent, William C.; Orszulak, Thomas A.; Antman, Elliott M.; Smith, Sidney C.; Alpert, Joseph S.; Anderson, Jeffrey L.; Faxon, David P.; Fuster, Valentín; Gibbons, Raymond J.; Gregoratos, Gabriel; Halperin, Jonathan L.; Hiratzka, Loren F.; Hunt, Sharon A.; Jacobs, Alice K.; Ornato, Joseph P.

doi:10.1161/01.cir.0000138790.14877.7d

Cited by 732 publications

(232 citation statements)

References 29 publications

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“…Recently, the treatment strategy for CAD has become more aggressive, as there have been improvements in surgical and interventional techniques and devices that are considered to have contributed to the safety of PCI and CABG surgery. 13,14 Although it has been recommended that the indications for coronary revascularization procedures such as PCI or CABG surgery should be determined not by coronary stenosis but by proven myocardial ischemia, 4 an increasing number of the patients have received these invasive treatments solely on the basis of the CAG findings. 17 Particularly, when these patients are scheduled to receive surgical treatment, coronary revascularization is more often performed irrespective of the existence of myocardial ischemia in the name of the prevention of perioperative complications.…”

Section: Discussionmentioning

confidence: 99%

“…The mode of treatment was selected by surgeons and catheter interventionalists based on the procedural guidelines of the American College of Cardiology/American Heart Association (ACC/AHA). 13,14 Coronary artery bypass graft surgery was selected when significant stenotic or occlusive lesions were observed in all 3 epicardial branches, when the stenotic lesion involved the left main trunk, or when stenotic lesions were observed in 2 epicardial branches of which at least 1 was unsuitable for PCI (due to a chronic total occlusion or diffuse stenotic lesion). Percutaneous coronary intervention was selected when the patients had PCI-suitable stenotic lesion(s) in 1 or 2 branches.…”

Section: Introductionmentioning

confidence: 99%

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Management of Coronary Artery Disease in Patients Undergoing Elective Abdominal Aortic Aneurysm Open Repair

Hosokawa¹,

Takano²,

Aoki³

et al. 2008

Clinical Cardiology

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Background The efficacy of prophylactic coronary revascularization with percutaneous coronary intervention (PCI) or coronary artery bypass graft (CABG) surgery in patients with abdominal aortic aneurysm (AAA) scheduled for open repair surgery remains controversial. Hypothesis Concomitant coronary artery disease (CAD) with no inducible ischemia can be medically treated in AAA patients undergoing open repair as long as the existence of CAD is recognized. Method A retrospective analysis of acute and long‐term outcomes was performed for 122 patients with AAA who underwent coronary arteriography (CAG) for preoperative evaluation followed by elective open repair. Results Preoperative CAG revealed no CAD in 54 patients (non‐CAD group) and the existence of CAD in 68 patients. Prophylactic PCI or CABG surgery was performed in 16 patients (CAD‐PCI/CABG group) with symptomatic angina, ischemia proven by pharmacological stress scintigraphy, or coexistence of reduced cardiac contraction and coronary stenosis in multiple vessels. Medical treatment was administered to 52 patients who had no signs of ischemia (CAD‐medical group). During the perioperative period, no cardiac event occurred irrespective of the existence of CAD. The long‐term outcomes in the CAD‐medical group were equivalent to those in the non‐CAD group. In the CAD‐PCI/CABG group, the cardiac event‐free rate was comparable with that of other groups, although mortality was higher. Conclusion In patients undergoing AAA open repair, medical treatment for concomitant CAD with no obvious inducible ischemia does not confer unfavorable outcomes. Although prophylactic coronary revascularization possibly prevents future cardiac events, it appears to be necessary in a very limited number of cases. Copyright © 2008 Wiley Periodicals, Inc.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Management of Coronary Artery Disease in Patients Undergoing Elective Abdominal Aortic Aneurysm Open Repair

Hosokawa¹,

Takano²,

Aoki³

et al. 2008

Clinical Cardiology

View full text Add to dashboard Cite

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“…Decisions about preoperative aspirin therapy in patients undergoing CABG are made widely on the basis of individual and institutional experiences [11][12][13]. Actually, the American Heart Association, American College of Cardiology [18], The Society of Thoracic Surgeons (STS) [19], and the European Association for Cardio-Thoracic Surgery [20] even make different recommendations about when preoperative aspirin therapy should be terminated, ranging between 2 and 10 days before elective cardiac operations.…”

mentioning

confidence: 99%

Preoperative Aspirin Use and Its Effect on Adverse Events in Patients Undergoing Cardiac Operations

Huang

Donneyong

Trivedi

et al. 2015

The Annals of Thoracic Surgery

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“…The NNE base preoperative prediction model of in‐hospital mortality in this study was built using preoperative risk scores of risk factors for mortality designated by the American College of Cardiology and American Heart Association 7, 26, 31. The in‐hospital mortality model corrects for age, sex, ejection fraction <40%, number of diseased vessels, left main disease >50%, white blood cell count, prior myocardial infarction, prior CABG surgery, presence of any vascular disease, presence of diabetes mellitus, history of renal failure, chronic obstructive pulmonary disease and urgent and emergent priority.…”

Section: Methodsmentioning

confidence: 99%

“…ST2 has been shown to be a sensitive biomarker of cardiac stress with statistically significant differences in concentration when stratified by age or sex 24, 25. We hypothesized that the use of these 3 biomarkers will improve the current risk prediction model used by the American College of Cardiology/American Heart Association CABG guidelines 26, 27, 28…”

Section: Introductionmentioning

confidence: 99%

Predictive Ability of Novel Cardiac Biomarkers ST2, Galectin‐3, and NT‐ProBNP Before Cardiac Surgery

Polineni

Parker

Alam

et al. 2018

JAHA

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BackgroundCurrent preoperative models use clinical risk factors alone in estimating risk of in‐hospital mortality following cardiac surgery. However, novel biomarkers now exist to potentially improve preoperative prediction models. An assessment of Galectin‐3, N‐terminal pro b‐type natriuretic peptide (NT‐ProBNP), and soluble ST2 to improve the predictive ability of an existing prediction model of in‐hospital mortality may improve our capacity to risk‐stratify patients before surgery.Methods and ResultsWe measured preoperative biomarkers in the NNECDSG (Northern New England Cardiovascular Disease Study Group), a prospective cohort of 1554 patients undergoing coronary artery bypass graft surgery. Exposures of interest were preoperative levels of galectin‐3, NT‐ProBNP, and ST2. In‐hospital mortality and adverse events occurring after coronary artery bypass graft were the outcomes. After adjustment, NT‐ProBNP and ST2 showed a statistically significant association with both their median and third tercile categories with NT‐ProBNP odds ratios of 2.89 (95% confidence interval [CI]: 1.04–8.05) and 5.43 (95% CI: 1.21–24.44) and ST2 odds ratios of 3.96 (95% CI: 1.60–9.82) and 3.21 (95% CI: 1.17–8.80), respectively. The model receiver operating characteristic score of the base prediction model (0.80 [95% CI: 0.72–0.89]) varied significantly from the new multi‐marker model (0.85 [95% CI: 0.79–0.91]). Compared with the Northern New England (NNE) model alone, the full prediction model with biomarkers NT‐proBNP and ST2 shows significant improvement in model classification of in‐hospital mortality.ConclusionsThis study demonstrates a significant improvement of preoperative prediction of in‐hospital mortality in patients undergoing coronary artery bypass graft and suggests that biomarkers can be used to identify patients at higher risk.

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ACC/AHA 2004 Guideline Update for Coronary Artery Bypass Graft Surgery: Summary Article

Cited by 732 publications

References 29 publications

Management of Coronary Artery Disease in Patients Undergoing Elective Abdominal Aortic Aneurysm Open Repair

Management of Coronary Artery Disease in Patients Undergoing Elective Abdominal Aortic Aneurysm Open Repair

Preoperative Aspirin Use and Its Effect on Adverse Events in Patients Undergoing Cardiac Operations

Predictive Ability of Novel Cardiac Biomarkers ST2, Galectin‐3, and NT‐ProBNP Before Cardiac Surgery

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