Document Detail


Preoperative clinical status but not waiting time predicts in-hospital outcomes of surgery in patients with left main coronary artery stenosis.
MedLine Citation:
PMID:  17917411     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Contoversy exists about the optimal operation time of the patients with left main coronary artery (LMCA) stenosis. We therefore, aimed to investigate the effect of waiting time on in-hospital morbidity and mortality in patients with LMCA stenosis and identify the risk factors associated with adverse cardiovascular events before and during surgery. One hundred seventy six patients with LMCA stenosis were divided into two groups according to the time period between coronary angiography and coronary artery bypass surgery (group 1: <or= 7 days, 94 patients; and group 2: > 7 days, 82 patients). Primary end points were death and major adverse cardiac event (MACE): in-hospital death, sustained ventricular tachycardia or ventricular fibrillation development, postoperative stay in the intensive care > 48 hrs and in hospital > 9 days. Demographic and clinical characteristics of patients in groups 1 and 2 were comparable. There was no difference between the two groups in terms of in-hospital morbidity, mortality and MACE. When we analyzed the differences between the patients with and without MACE, the patients who experienced MACE were older (p = 0.001), and had higher degree of LMCA stenosis (p = 0.01), higher degree of right coronary artery stenosis (p = 0.02), higher blood urea level (p = 0.003), and higher incidence of unstable angina or myocardial infarction within 2 weeks (p = 0.001). Independent risk factors for MACE were unstable angina or myocardial infarction within 2 weeks, age more than 70 years and stenosis more than 75% in the LMCA. These results suggest that preoperative clinical status but not waiting time predicts in-hospital surgical outcomes in LMCA stenosis.
Authors:
Ibrahim Sari; Zubeyir Acar; Zekeriya Nurkalem; Nevzat Uslu; Vedat Davutoglu; Mehmet Ates; Orhan Ozer; Mehmet Eren; Mehmet Aksoy
Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  The Tohoku journal of experimental medicine     Volume:  213     ISSN:  0040-8727     ISO Abbreviation:  Tohoku J. Exp. Med.     Publication Date:  2007 Oct 
Date Detail:
Created Date:  2007-10-05     Completed Date:  2007-12-06     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0417355     Medline TA:  Tohoku J Exp Med     Country:  Japan    
Other Details:
Languages:  eng     Pagination:  173-80     Citation Subset:  IM    
Affiliation:
Gaziantep University, School of Medicine, Department of Cardiology, Gaziantep, Turkey. drisari@yahoo.com
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MeSH Terms
Descriptor/Qualifier:
Aged
Coronary Angiography
Coronary Artery Bypass / statistics & numerical data
Coronary Stenosis / diagnosis,  mortality,  pathology,  surgery*
Coronary Vessels / pathology*
Female
Health Status*
Humans
Length of Stay*
Logistic Models
Male
Middle Aged
Multivariate Analysis
Predictive Value of Tests
Preoperative Care
Time Factors
Treatment Outcome
Waiting Lists*

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


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