The Year in Cardiothoracic and Vascular Anesthesia: Selected Highlights From 2016

Depression and poor outcome after an acute coronary event: Clarification of risk periods and mechanisms

“…This study investigated the impact of the presence and timing of depression on the likelihood of hospital readmission and/or death at 1 and 12 months following admission for an ACS event, a focus of intrinsic importance and currently salient in light of increasingly successful cardiac management (Forman et al, 2016; Ramakrishna et al, 2016) leading to decreased morbidity and mortality rates. In relation to the latter issue, only eight (2.3%) sample patients died over the 12-month follow-up period.…”

“…Clarification remains pertinent, given the prevalence (15–31%) of depression in patients with coronary artery disease and its impact (Lesperance et al, 1996; Lichtman et al, 2014; Rudisch and Nemeroff, 2003). It is also unclear whether recent improvements in cardiovascular technology and management approaches (Forman et al, 2016; Ramakrishna et al, 2016)—which have resulted in improved cardiac outcomes (i.e. distinctive reductions in subsequent morbidity and mortality rates)—have impacted on the previously identified risk.…”

Effect of thrombelastography on timing of coronary artery bypass grafting

“…Platelet inhibition rate is a reference index of efficiency of antiplatelet drugs. Usually, inhibition of AA platelet stimulation <50% or ADP% inhibition <30% suggested inadequate antiplatelet efficacy; inhibition rate >76% indicated relatively high platelet inhibition and clinical attention should be paid to potential risk of bleeding ( 15 , 16 ). For patients taking antiplatelet medication before surgery, surgical timing can be selected according to the inhibition rate so as to better prevent the preoperative thrombus formation and intraoperative massive hemorrhage.…”