Is Peripheral Artery Disease an Independent Predictor of Isolated Coronary Artery Bypass Outcome?

Autor: Massimo Bonacchi, Amalia Ioanna Moula, Linda Renata Micali, Sandro Gelsomino, Cecilia Tetta, Francesco Matteucci, Andrea Grasso, Aleksander Dokollari, Guido Sani, Edvin Prifti, Orlando Parise, Marco De Martino
Přispěvatelé: CTC, RS: Carim - V04 Surgical intervention
Rok vydání: 2020
Předmět:
Male
Cardiac output
Percutaneous
SURGERY
Coronary artery bypass
Coronary Artery Disease
030204 cardiovascular system & hematology
law.invention
Coronary artery bypass surgery
0302 clinical medicine
Risk Factors
law
030212 general & internal medicine
Stroke
Incidence
VASCULAR-DISEASE
Middle Aged
Prognosis
TIME
Survival Rate
Treatment Outcome
medicine.anatomical_structure
Italy
Cardiology
Female
REVASCULARIZATION
Cardiology and Cardiovascular Medicine
Artery
Pulmonary and Respiratory Medicine
medicine.medical_specialty
STENOSIS
03 medical and health sciences
Internal medicine
Peripheral arterial disease
MANAGEMENT
medicine
Cardiopulmonary bypass
Humans
PERIOPERATIVE STROKE
cardiovascular diseases
Propensity Score
Aged
Retrospective Studies
business.industry
MORTALITY
LONG-TERM SURVIVAL
Vascular surgery
medicine.disease
body regions
Peripheral vascular disease
business
Kidney disease
Zdroj: Heart Lung and Circulation, 29(10), 1502-1510. Elsevier Science
ISSN: 1443-9506
DOI: 10.1016/j.hlc.2020.01.013
Popis: The aim was to use a propensity score-based analysis to determine the impact of peripheral artery disease (PAD) on early outcomes after coronary artery bypass surgery grafting (CABG) in patients with PAD.We conducted a multicentre retrospective analysis of 11,311 consecutive patients who underwent CABG between 1997 and 2017. Patients with previous or concomitant vascular surgery were excluded. The main endpoints were death, stroke, and limb ischaemia requiring percutaneous or surgical revascularisation. Subgroup analyses were performed to test the interaction of PAD with concomitant factors.There was no difference in mortality in patients with and without PAD (p=0.06 and p=0.179, respectively). Patients with PAD had a greater incidence of stroke (p=0.04), acute kidney disease (p=0.003), and limb ischaemia requiring interventions (p0.001) than those without PAD. The use of off-pump or no-touch aortic techniques did not influence the effect of PAD on the outcomes. Early mortality rate increased in patients with PAD when associated with long cardiopulmonary bypass, cross-clamp times (both p0.001), and postoperative low cardiac output (p=0.01).The presence of PAD is associated, independently of other factors, with greater incidence of stroke, acute kidney disease, and limb ischaemia following CABG, irrespective of the technique employed. Operative mortality was greater in patients with PAD only when associated with long cardiopulmonary bypass and aortic cross-clamp times, and low cardiac output.
Databáze: OpenAIRE
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