Predictors and Outcomes of Coronary Artery Bypass Grafting: A Systematic and Untargeted Analysis of More Than 120,000 Individuals and 1,300 Disease Traits
Autor: | Teemu J. Niiranen, Anni Kauko, Joonatan Palmu, FinnGen, Jenni Aittokallio |
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Rok vydání: | 2021 |
Předmět: |
medicine.medical_specialty
Anemia Population Coronary Artery Disease 030204 cardiovascular system & hematology Cohort Studies 03 medical and health sciences 0302 clinical medicine Percutaneous Coronary Intervention 030202 anesthesiology Risk Factors Internal medicine Medicine Humans cardiovascular diseases Coronary Artery Bypass education Retrospective Studies education.field_of_study Framingham Risk Score business.industry Proportional hazards model Hazard ratio medicine.disease Confidence interval Anesthesiology and Pain Medicine Treatment Outcome Quartile Cardiology and Cardiovascular Medicine business Cohort study |
Zdroj: | Journal of cardiothoracic and vascular anesthesia. 35(11) |
ISSN: | 1532-8422 |
Popis: | Objective To perform an untargeted data-driven analysis on the correlates and outcomes of coronary artery bypass grafting (CABG). Design FinnGen cohort study. Setting The authors collected information on up to 1,327 disease traits before and after CABG from nationwide healthcare registers. Participants A mixed population and patient sample of 127,911 individuals including 3,784 CABG patients. Interventions The authors assessed the association between (1) traits and incident CABG and (2) CABG and incident traits using multivariate-adjusted Cox models. Main results Patients who underwent CABG and were in the fourth quartile of a risk score based on the top predictors of mortality had 12.2-fold increased risk of dying (95% confidence interval [CI], 10.3-14.5) compared with those in the first quartile. Cardiovascular disease (CVD) and CVD risk factors were most strongly associated with incident CABG. However, CABG was associated with death due to cardiac causes (hazard ratio [HR], 3.7; 95% CI, 3.5-4.0) or other causes (HR, 2.5; 95% CI, 2.4-2.7). CABG also was related to increased risk of several non-CVD traits, including anemia (HR, 3.4; 95% CI, 2.8-4.1), gastrointestinal disorders (HR, 2.2; 95% CI, 1.8-2.6), acute renal failure (HR, 4.2; 95% CI, 3.5-5.1), septicemia (HR, 3.6; 95% CI, 3.1-4.1), lung cancer (HR, 2.3; 95% CI, 1.9-2.8), Alzheimer's disease (HR, 2.5; 95% CI, 2.2-2.7), and chronic obstuctive pulmonary disease (HR, 2.5; 95% CI, 2.2-2.9). Conclusions Known CVD risk factors associate most strongly with incident CABG. However, CABG is associated with increased risk of several, somewhat unexpected, non-CVD traits. More detailed study of these links is warranted to establish potential causality and pathogenesis. |
Databáze: | OpenAIRE |
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