A preoperative E/e' ratio >15 was independently associated with increased 1-year major adverse cardiac events (HR 2.1; 95% CI 1.4-3.1; P=0.001) in patients undergoing off-pump CABG.
Observational (n=1,048)
Does a preoperative E/e' ratio > 15 predict major adverse cardiac events in adults undergoing elective off-pump coronary artery bypass graft surgery?
A preoperative E/e' ratio > 15 is an independent predictor of 30-day and 1-year MACE in patients undergoing elective off-pump CABG, providing a useful tool for preoperative risk stratification.
Hazard Ratio: 2.1 (95% CI 1.4–3.1)
p-value: p=0.001
BACKGROUND: The ratio of early transmitral flow velocity to early diastolic velocity of the mitral annulus (E/e') correlates with left ventricular (LV) filling pressure. In particular, an E/e' ratio more than 15 is an excellent predictor of increased LV filling pressure. The authors evaluated the prognostic implications of preoperative estimated LV filling pressure, assessed by E/e' ratio, in patients undergoing off-pump coronary artery bypass graft surgery. METHODS: This observational study investigated 1,048 consecutive adults undergoing elective off-pump coronary artery bypass graft surgery. The primary outcome was occurrence of major adverse cardiac events (MACE), defined as a composite of death, myocardial infarction, malignant ventricular arrhythmia, cardiac dysfunction, or need for new revascularization. Logistic regression and survival analyses were performed. RESULTS: An E/e' ratio more than 15 was independently associated with 30-day MACE (odds ratio 2.4, 95% CI 1.4-3.9, P = 0.001) and 1-yr MACE (hazard ratio 2.1, 95% CI 1.4-3.1, P = 0.001), irrespective of underlying LV ejection fraction. MACE free 1-yr survival rate was significantly decreased in patients with E/e' >15, irrespective of underlying LV ejection fraction. CONCLUSIONS: Increased LV filling pressure, assessed by E/e' ratio, is an independent predictor of 30-day and 1-yr MACE in patients who undergo elective off-pump coronary artery bypass graft surgery. These findings indicate that measurements of E/e' may assist in preoperative risk stratification of these patients.
Lee et al. (Fri,) conducted a observational in Elective off-pump coronary artery bypass graft surgery (n=1,048). Preoperative E/e' ratio > 15 vs. Preoperative E/e' ratio ≤ 15 was evaluated on Major adverse cardiac events (MACE), defined as a composite of death, myocardial infarction, malignant ventricular arrhythmia, cardiac dysfunction, or need for new revascularization (HR 2.1, 95% CI 1.4-3.1, p=0.001). A preoperative E/e' ratio >15 was independently associated with increased 1-year major adverse cardiac events (HR 2.1; 95% CI 1.4-3.1; P=0.001) in patients undergoing off-pump CABG.