Asymptomatic long-term survivors of coronary artery bypass surgery enjoy a quality of life equal to the general population

Bradshaw, Pamela J.; Jamrozik, Konrad; Gilfillan, Ian; Thompson, Peter L.

doi:10.1016/j.ahj.2005.04.007

Cited by 31 publications

(20 citation statements)

References 19 publications

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“…In addition, there were significantly higher rates of angina and CVD-related hospitalization with OPCAB, all of which contributed significantly to adverse postoperative quality of life and are common reasons for readmission after CABG. 17,18 The present study revealed a strong association between OPCAB surgery and incomplete revascularization. This finding provides further supporting evidence for concerns about incomplete revascularization associated with off-pump technique.…”

Section: Discussionmentioning

confidence: 82%

Increasing Long-Term Major Vascular Events and Resource Consumption in Patients Receiving Off-Pump Coronary Artery Bypass

Zheng

Yuan

et al. 2010

Circulation

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Background-Despite its widespread use and short-term efficacy, substantial uncertainty remains about the long-term outcomes and cost-effectiveness of off-pump coronary artery bypass (OPCAB). Methods and Results-A retrospective review of prospectively collected data was conducted of 6665 consecutive patients undergoing isolated coronary artery bypass graft (CABG) at our institution during 1999 to 2006. All patients were followed up until September 30, 2008. Short-and long-term outcomes were compared between OPCAB and conventional CABG. The 2 main long-term outcome measures were repeat revascularization and the composite outcome of major vascular events. Cost comparison at 2 years in a propensity-matched sample during follow-up was also a study interest. The overall mean baseline age was 60.3Ϯ8.6 years, and 17.0% were women. Compared with conventional CABG, patients who underwent OPCAB had lower rates of atrial fibrillation (Pϭ0.003) and requirements for blood transfusion (Pϭ0.03) and ventilation time Ͼ24 hours (PϽ0.001). After an average of 4.5 years of follow-up, the rates of repeat revascularization (adjusted hazard ratio, 1.40; 95% confidence interval, 1.03 to 1.89) and major vascular events (adjusted hazard ratio, 1.23; 95% confidence interval, 1.09 to 1.39) were significantly higher in the OPCAB than the conventional CABG group. At 2 years, OPCAB was associated with increased additional direct costs per patient compared with conventional CABG and had a similar survival rate. Conclusions-Compared with conventional CABG, OPCAB is associated with small short-term gain but increased long-term risks of repeat revascularization and major vascular events, especially among high-risk patients. Moreover, OPCAB consumes more resources and is less cost-effective in the long run. (Circulation. 2010;121:1800-1808.)Key Words: coronary artery bypass grafting Ⅲ coronary disease Ⅲ coronary artery bypass, off-pump Ⅲ surgery C urrently, increasing volume of off-pump coronary artery bypass (OPCAB) has been noted not only in Western countries but also in developing countries such as China and India. OPCAB was first introduced in China in 1996, 1 and Ͼ50 major cardiovascular centers across the country have routinely used the technique. On the basis of a large registration study involving Ϸ10 000 patients from 35 centers across China, 2 OPCAB accounts for Ͼ70% of all coronary artery bypass graft (CABG) surgeries done in these centers, a proportion that was Ϸ3 times as high as that reported in other populations such as the United States. 3 Unfortunately, when confronted with the growing volume, we seldom have adequate evidence from the literature. Several randomized controlled trials were reported but tended either to be small or to have short follow-up (seldom Ͼ5 years). 4 -6 A recent randomized controlled trial involving 18 centers and 2203 patients was released, but the patients included were mostly male. 5 Studies with long-term follow-up exist but tend to emphasize primarily all-cause mortalities, 7 and data on long-term adver...

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Section: Discussionmentioning

confidence: 82%

Increasing Long-Term Major Vascular Events and Resource Consumption in Patients Receiving Off-Pump Coronary Artery Bypass

Zheng

Yuan

et al. 2010

Circulation

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“…A previous follow-up study of persons who had coronary artery bypass graft surgery that matched the cohort to the National Death Index identified no deaths outside Western Australia. 24 The prevalence of CHD may have also been overestimated by failures in the linkage of hospital records to death records, but the audit processes of the WADLS suggest that such failures are rare (0.11%). 4 Our methods will not have captured MIs that have been either undiagnosed or diagnosed and treated in primary care.…”

Section: Briffa Et Al Recurrent Coronary Heart Disease Trends 111mentioning

confidence: 99%

Population Trends of Recurrent Coronary Heart Disease Event Rates Remain High

Briffa

Hobbs

Tonkin

et al. 2011

Circ: Cardiovascular Quality and Outcomes

127

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Background-Survivors of nonfatal coronary heart disease (CHD) can reduce their risk of further events by various preventive interventions. The impact of such measures as delivered over 11 years, on population rates of subsequent major CHD events, has not been extensively studied. This study determined population trends in the prevalence of clinically manifest CHD and the proportion of major CHD events that occur in this population. Methods and Results-A population longitudinal person-based event-linked file of CHD extracted from State HospitalMorbidity Data and Death Registry for 1980 to 2005 was used to identify, for each year from 1995 to 2005, survivors who had a hospitalization for CHD over the previous 15 years (population with established CHD), and to examine the occurrence of CHD death and hospitalization with a principal diagnosis of myocardial infarction in both populations with and without established CHD. The average annual age-standardized prevalence of CHD in the Perth metropolitan region (population 1.6 million) was 28 373 (8.8%) in men and 14 966 (4.0%) in women. Age-specific prevalence increased exponentially with age, from Ͻ1% in 35 to 39 age group to 42% in 80 to 84 age group in men and half that in women. The percentage of total CHD events (nϭ28 941) that occurred in the population with established CHD was approximately 43% in both men and women, 55% and 51%, respectively, for CHD death and 35% and 36% for nonfatal myocardial infarction. Conclusions-More than 40% of major CHD events annually occur in persons with manifest disease, highlighting the imperative to implement systems of care that support effective secondary prevention. (Circ Cardiovasc Qual Outcomes.

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“…In Iran, coronary heart disease is allocated the first place by 21% [10]. The quality of life is considered as the sign of quality for health care and a part of health plan, and its measurement in chronic diseases is a useful guide to improve quality of care [5], while in some studies the quality of life of patients has been described unfavorable after cardiovascular surgeries [11]. One of the most effective measures for efficacy of cardiac surgery and decrease of its complications is cardiac rehabilitation [7].…”

Section: Introductionmentioning

confidence: 99%

Evaluating the Effect of Cardiac Rehabilitation Care Plan on Quality of Life of Patients Undergoing Coronary Artery Bypass Graft Surgery

Masoumi

Kazemi

Khani

et al. 2017

ijcp

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Introduction: Cardiovascular surgeries are among the conventional surgeries aimed at increasing the survival rate and improving the quality of life of patients. This study aimed to evaluate the effect of cardiac rehabilitation on quality of life of patients undergoing Coronary artery bypass graft (CABG) surgery. Methods: This was a semi-experimental study performed on 160 patients undergoing CABG surgery. The rehabilitation program was carried out for 13 weeks (three sessions per week) in 40 sessions, six weeks after the CABG surgery. The MacNew standard questionnaire and the general health questionnaire (S-f 36) were completed before the beginning of rehabilitation sessions as well as after completion of these sessions by patients. Results: According to the results, the quality of life of patients significantly increased in the physical and emotional areas after the rehabilitation program. The results also indicated that there was a significant difference between various levels of research in the physical functioning variables, dysfunction due to physical health, dysfunction due to emotional health, energy/fatigue of individuals, emotional well-being, social functioning, pain, and general health. Conclusions:The present results indicated the improved quality of life of patients in all the areas after cardiac rehabilitation intervention, compared to before that. Therefore, paying more attention to cardiac rehabilitation is necessary due to its positive effects on increasing the quality of life of patients.

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Asymptomatic long-term survivors of coronary artery bypass surgery enjoy a quality of life equal to the general population

Cited by 31 publications

References 19 publications

Increasing Long-Term Major Vascular Events and Resource Consumption in Patients Receiving Off-Pump Coronary Artery Bypass

Increasing Long-Term Major Vascular Events and Resource Consumption in Patients Receiving Off-Pump Coronary Artery Bypass

Population Trends of Recurrent Coronary Heart Disease Event Rates Remain High

Evaluating the Effect of Cardiac Rehabilitation Care Plan on Quality of Life of Patients Undergoing Coronary Artery Bypass Graft Surgery

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