| Prognosis of perioperative myocardial infarction after off-pump coronary artery bypass surgery. | |
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MedLine Citation:
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PMID: 19734836 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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AIM: Perioperative myocardial infarction (PMI) is associated with long-term morbidity and mortality. CKMB cut-off level and importance of Q-wave MI have not been specifically studied after off-pump coronary artery bypass (OPCAB) surgery. The aim of this paper was to study the impact of PMI (CKMB >/= 20 times the upper normal limit [UNL] 100 mg/L) and CKMB rise (5-20 UNL) on survival and recurrent major adverse cardiac event (MACE) after OPCAB surgery. METHODS: One thousand consecutive prospectively followed OPCAB patients operated between September 1996 and March 2004 were analyzed. Follow-up was complete in 97% of the cohort. Average follow-up was 66 +/- 28 months. RESULTS: Overall and cardiac survival at 10 years was 70 +/- 2.6% and 88 + 2.3%, respectively. Evolving MI (EMI) occurred in 1.8%, postoperative non-Q MI (NQMI) in 1.3%, and Q-wave MI (QMI) in 2.0%. Operative mortality was higher in PMI patients (P < 0.001). After adjusting for risk factors, survivors of EMI (HR: 2.0) and QMI (HR: 2.3) but not NQMI had a lower life expectancy and a higher long-term cardiac mortality (EMI: HR: 3.5; QMI: HR: 4.3) compare to non-PMI patients. EMI and QMI were associated with a decrease MACE-free survival. CKMB 5-10 UNL did not affect overall and cardiac mortality. CKMB 10-20 UNL was associated to lower cardiac survival. CONCLUSIONS: PMI (CKMB > 20 UNL) was a strong predictor of operative mortality. QMI and EMI were predictors of long-term mortality and cardiac morbidity after OPCAB surgery. CKMB 10-20 UNL affected long-term cardiac survival but not overall survival. |
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Authors:
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F Vanden Eynden; R Cartier; B Marcheix; P Demers; D Bouchard |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: The Journal of cardiovascular surgery Volume: 50 ISSN: 0021-9509 ISO Abbreviation: J Cardiovasc Surg (Torino) Publication Date: 2009 Aug |
Date Detail:
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Created Date: 2009-09-07 Completed Date: 2010-01-07 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 0066127 Medline TA: J Cardiovasc Surg (Torino) Country: Italy |
Other Details:
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Languages: eng Pagination: 535-43 Citation Subset: IM |
Affiliation:
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Department of Cardiac Surgery, Erasmus Hospital, Free University of Brussels, Brussels, Belgium. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Aged Biological Markers / blood Coronary Artery Bypass, Off-Pump / adverse effects, mortality* Creatine Kinase, MB Form / blood* Electrocardiography Female Humans Logistic Models Male Middle Aged Myocardial Infarction / blood, etiology, mortality* Predictive Value of Tests Prognosis Proportional Hazards Models Retrospective Studies Risk Assessment Risk Factors Survival Analysis Time Factors Up-Regulation |
| Chemical | |
Reg. No./Substance:
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0/Biological Markers; EC 2.7.3.2/Creatine Kinase, MB Form |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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