Document Detail


Predictors of new malignant ventricular arrhythmias after coronary surgery: a case-control study.
MedLine Citation:
PMID:  15120824     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: We sought to investigate the relationship between perioperative factors and the occurrence of ventricular tachycardia (VT) and ventricular fibrillation (VF), as well as the impact of VT/VF on early and late mortality. BACKGROUND: Both VT and VF are rare but serious complications after coronary artery bypass graft surgery (CABG), and their etiology and implications remain uncertain. METHODS: Data on 4,411 consecutive patients undergoing CABG (1,154 [25.8%] had off-pump surgery) between April 1996 and September 2001 were extracted from a prospective database and analyzed. Odds ratios (ORs) describing associations between possible risk factors and VT/VF were estimated separately. Factors observed to be significantly associated with VT/VF were further investigated using multivariate logistic regression. RESULTS: Sixty-nine patients suffered VT/VF (1.6%). There were 61 (1.4%) in-hospital/30-day deaths, 15 among patients who had postoperative VT/VF (21.7%). Patient factors independently associated with an increase in the odds of VT/VF included age <65 years, female gender, body mass index <25 kg/m(2), unstable angina, moderate or poor ejection fraction, and the need for inotropes and an intra-aortic balloon pump (OR 1.72 to 4.47, p < 0.05). After adjustment, off-pump surgery was associated with a substantial but nonsignificant protective effect against VT/VF (OR 0.53, 95% confidence interval [CI] 0.25 to 1.13; p = 0.10). Actuarial survival at two years was 98.2% among patients who had VT/VF and who survived to discharge/30 days, compared with 97.0% for the control group (adjusted hazard ratio 0.96 (95% CI 0.40 to 2.31, p = 0.92). CONCLUSIONS: The incidence of VT/VF is low in patients undergoing coronary surgery but is associated with high in-hospital mortality. The late survival of the discharged VT/VF patients compares favorably with that of controls.
Authors:
Raimondo Ascione; Barnaby C Reeves; Kirkpatrick Santo; Nouman Khan; Gianni D Angelini
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Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Journal of the American College of Cardiology     Volume:  43     ISSN:  0735-1097     ISO Abbreviation:  J. Am. Coll. Cardiol.     Publication Date:  2004 May 
Date Detail:
Created Date:  2004-05-03     Completed Date:  2004-06-10     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  8301365     Medline TA:  J Am Coll Cardiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1630-8     Citation Subset:  AIM; IM    
Affiliation:
Bristol Heart Institute, Bristol Royal Infirmary, Bristol, United Kingdom. R.Ascione@bristol.ac.uk
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Aged
Body Mass Index
Case-Control Studies
Coronary Artery Bypass*
Coronary Disease / epidemiology,  surgery
Female
Follow-Up Studies
Great Britain / epidemiology
Humans
Male
Middle Aged
Postoperative Complications / epidemiology,  etiology*
Predictive Value of Tests
Prospective Studies
Risk Factors
Statistics as Topic
Survival Analysis
Tachycardia, Ventricular / epidemiology,  etiology*
Treatment Outcome
Ventricular Fibrillation / epidemiology,  etiology*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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