Coronary artery bypass grafting in South Asian patients: Impact of gender

Khan, Jamal Kabeer; Shahabuddin, Syed; Khan, Samiullah; Bano, Gulshan; Hashmi, Shiraz; Sami, Shahid Ahmed

doi:10.1016/j.amsu.2016.05.018

Cited by 6 publications

(5 citation statements)

References 23 publications

(27 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…We also compared the outcome of CABG with and without LIMA in the elective and urgent groups and found that CABG with LIMA is associated with reduced mortality and major morbidity in both the elective and urgent groups. Similarly, female sex is also a commonly referred factor precluding the use of IMA, however, in our study, it was not considered contraindicated despite the fact that they are at high risk of mortality [17]. In the no LIMA group, patients were of older age as compared to the LIMA group and presented with acute myocardial infarction, which was comparable with other studies [6,16].…”

Section: Discussionsupporting

confidence: 87%

Comparing Outcomes in Patients Undergoing Coronary Artery Bypass Grafting With and Without Using the Internal Mammary Artery in a Tertiary Care Hospital

Khan¹,

Shahabuddin²,

Hashmi³

et al. 2020

Cureus

Self Cite

View full text Add to dashboard Cite

The left internal mammary artery in coronary artery bypass grafting (CABG) is considered to be an important intraoperative quality indicator with excellent long-term results. The purpose of this study is to compare the early outcomes of CABG with and without the left internal mammary artery (LIMA) in the South Asian population and to look for the utilization of LIMA as per the recommendations of the Society of Thoracic Surgeons in a developing country. Materials and methods A retrospective review was carried out for all patients who underwent CABG from 2010 to 2015. Patients were divided into two groups on the basis of whether LIMA was used (Group I) or not used (Group II) as a conduit. Both groups were further subdivided into elective and urgent. Preoperative, intraoperative, and postoperative variables were recorded and compared. Results After exclusion, a total of 2619 patients underwent isolated CABG surgery during the required duration. The LIMA was used in 94% of the patients (n=2472) while 147 patients underwent CABG without LIMA. The use of LIMA was associated with significantly lower mortality (2% LIMA vs 8.8% no LIMA), as well as a decrease in major comorbidity, stroke, and prolonged ventilation. In the subgroup analysis, LIMA usage in elective and urgent cases was associated with significantly lower mortality (elective 1.6% LIMA vs 7.4% No LIMA) (urgent 4.8% LIMA vs 15.7 % no LIMA)) and major morbidity. Conclusion The outcomes of CABG procedures without LIMA were not encouraging. Our results support compliance with standard adult cardiac surgery quality-of-care guidelines.

show abstract

Section: Discussionsupporting

confidence: 87%

Comparing Outcomes in Patients Undergoing Coronary Artery Bypass Grafting With and Without Using the Internal Mammary Artery in a Tertiary Care Hospital

Khan¹,

Shahabuddin²,

Hashmi³

et al. 2020

Cureus

Self Cite

View full text Add to dashboard Cite

show abstract

“…The multivariate Cox regression analysis identified neurological dysfunction, renal impairment, and left ventricular dysfunction as pre-operative determinants that were independently associated with 30-day mortality after CABG. In this study, 11.8% of the subjects presented with neurological dysfunction which is higher compared with rates of 1.4%, 2.4%, 6.3%, and 6.8% in the previous studies [13], [15], [16]. Thirty-day mortality in patients of this study with neurological dysfunction was 1.9% while mortality in patients without this condition is 0.6%.…”

Section: Discussioncontrasting

confidence: 60%

“…We further note that 6.8% of our subjects presented with impaired renal function, a higher rate than those reported in the EuroSCORE, STS studies, and a study in Taiwan [12], [16]. Patients with this condition tend to have a higher incidence of three-vessel disease and involvement of the left main coronary artery.…”

Section: Discussioncontrasting

confidence: 40%

Pre-operative, Intraoperative, and Post-operative Determinants Associated with 30-day Mortality Post-Coronary Artery Bypass Graft: A Retrospective Cohort Study

Rinaldi

Sudaryo

Mansjoer

2022

Open Access Maced J Med Sci

View full text Add to dashboard Cite

Background: Various determinants of 30-day mortality risk in CABG patients have been formulated into certain scoring models such as the EuroSCORE and ACEF model. However, these models only consider preoperative parameters while excluding intraoperative, postoperative, and perioperative parameters. Currently, the prior research has increasingly emphasized the role of these excluded parameters as determinants of post-CABG mortality. Furthermore, there are differences in mortality rate of CABG procedures in Indonesia when compared with other countries. Hence, this study aimed to identify preoperative, intraoperative, and postoperative determinants of 30-day mortality after CABG surgery in Indonesian population. Methods: In this retrospective cohort study, secondary data were obtained from the medical records of 263 patients aged ≥ 18 years who underwent CABG at a single center in Indonesia during the year 2012–2015. Selected preoperative, intraoperative, postoperative, and perioperative determinants were analyzed in both bivariate and multivariate Cox regression models to identify determinants associated with 30-day mortality. Results: The 30-day mortality rate after CABG was 11.8%. Multivariate analysis identified neurological dysfunction (HR 6.16; 95% CI 2.42-15.66), renal impairment (HR 3.9; 95% CI 1.46-10.38), left ventricle dysfunction (HR 3.53;95% CI 1.55-8.03), aortic clamp duration (HR 3.7;95% CI 1.53-8.96), surgery duration (HR 3.85;95% CI 1.39-10.70), postoperative thrombocytopenia (HR 3.99;95% CI 1.72-9.23), and postoperative intra-aortic balloon pump (HR 10.98; 95% CI 4.77-25.28) as significant determinants associated with 30-day mortality after CABG Conclusions: Neurological dysfunction, renal impairment, left ventricle dysfunction, aortic clamp duration, surgery duration, postoperative thrombocytopenia, and postoperative intra-aortic balloon pump were independent determinants for 30-day mortality after CABG.

show abstract

“…Females were found to have a significantly higher risk of mortality following surgery but the pattern of morbidity was comparable. [25] However, all procedures were performed under CPB and cardioplegic arrest. Women may benefit more than men from avoidance of CPB.…”

Section: Discussionmentioning

confidence: 99%

Female Gender is not a Risk Factor for Early Mortality after Coronary Artery Bypass Grafting

et al. 2019

View full text Add to dashboard Cite

Background: The female gender is considered as a risk factor for morbidity and mortality after coronary artery bypass grafting (CABG). Aim: In this analysis, we assessed the impact of female gender on early outcome after CABG. Study Design: This is a retrospective analysis of data from our center situated in South India. Statistical Analysis: Patients were categorized according to gender and potential differences in pre-operative and post-operative factors were explored. Significant risk factors were then built in a multivariate model to account for differences in predicting gender influence on surgical outcome. Methods: 773 consecutive patients underwent first time CABG between January 2015 and December 2016. 96.77% of cases were performed using off-pump technique. 132 (17.07%) patients were females. These patients formed the study group. Results: The in-house/ 30-day mortality in females was similar to that of males (3.03% vs. 3.12%, p value 0.957). Mediastinitis developed more commonly in females (5.35% vs. 1.30%; p value 0.004) compared to males. There were more re-admissions to hospital for female patients (21.37% in females vs. 10.14% in males, p value <0.001). In multivariate analysis using logistic regression; there was a significant association between age (OR 1.08), chronic obstructive airway disease (OR 4.315), and use of therapeutic antibiotics (OR 6.299), IABP usage (OR 11.18) and renal failure requiring dialysis (OR 28.939) with mortality. Conclusions: Early mortality in females was similar to that of males. Females were associated with higher rate of wound infection and readmission to hospital.

show abstract

Coronary artery bypass grafting in South Asian patients: Impact of gender

Cited by 6 publications

References 23 publications

Comparing Outcomes in Patients Undergoing Coronary Artery Bypass Grafting With and Without Using the Internal Mammary Artery in a Tertiary Care Hospital

Comparing Outcomes in Patients Undergoing Coronary Artery Bypass Grafting With and Without Using the Internal Mammary Artery in a Tertiary Care Hospital

Pre-operative, Intraoperative, and Post-operative Determinants Associated with 30-day Mortality Post-Coronary Artery Bypass Graft: A Retrospective Cohort Study

Female Gender is not a Risk Factor for Early Mortality after Coronary Artery Bypass Grafting

Contact Info

Product

Resources

About