Key result
Increased preoperative carotid intima-media thickness (≥0.9 mm) was independently associated with a higher risk of a 30-day composite of cardiovascular morbidity endpoints after off-pump coronary artery bypass surgery (OR 1.719).
Why the study?
Does increased carotid intima-media thickness predict a composite of cardiovascular morbidity in patients undergoing off-pump coronary artery bypass surgery?
Cohort (n=407)
No
Does increased carotid intima-media thickness predict a composite of cardiovascular morbidity in patients undergoing off-pump coronary artery bypass surgery?
Odds Ratio: 1.719 (95% CI 1.108–2.666)
Absolute Event Rate: 34.4% vs 24%
p-value: p=0.016
Preoperative assessment of carotid IMT independently predicts a 30-day composite of cardiovascular morbidity in patients undergoing off-pump coronary artery bypass surgery.
Carotid IMT may refine risk stratification after OPCAB; extends prior prognostic data but leaves prospective validation open.
Carotid intima-media thickness (IMT) is a well-known predictor of adverse outcomes in the ischemic heart disease patients; however, evidence is lacking in patients undergoing off-pump coronary artery bypass surgery (OPCAB). Data from 407 patients who underwent OPCAB between April 2013 and August 2016 were retrospectively reviewed. A composite of cardiovascular morbidity endpoints was defined as the presence of stroke, acute myocardial infarction, new cardiac arrhythmia (newly developed atrial fibrillation, atrial flutter, or atrioventricular block), cardiovascular death, or cerebrovascular death within 30 days after surgery. Increased carotid IMT was defined as ≥0.9 mm on one or both sides. The incidence of a composite of cardiovascular morbidity endpoints was 24.0% in the normal IMT group (n = 221) and 34.4% in the increased IMT group (n = 186) (p = 0.021). Multivariable analysis revealed increased IMT (odds ratio 1.719, 95% confidence interval 1.108 to 2.666, p = 0.016) and preoperative renal replacement therapy (odds ratio 4.264, 95% confidence interval 1.679 to 10.829, p = 0.002) as independent predictors of a composite of cardiovascular morbidity endpoints. In patients undergoing OPCAB, preoperative assessment of carotid IMT may help predicting the development of a postoperative composite of cardiovascular morbidity endpoints.
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Ham et al. (2018) conducted a cohort in Coronary artery disease requiring off-pump coronary artery bypass surgery (n=407). Increased carotid intima-media thickness (≥0.9 mm) vs. Normal carotid intima-media thickness (<0.9 mm) was evaluated on 30-day composite of cardiovascular morbidity endpoints (stroke, acute myocardial infarction, new cardiac arrhythmia, cardiovascular death, or cerebrovascular death) (OR 1.719, 95% CI 1.108-2.666, p=0.016). Increased preoperative carotid intima-media thickness (≥0.9 mm) was independently associated with a higher risk of a 30-day composite of cardiovascular morbidity endpoints after off-pump coronary artery bypass surgery (OR 1.719).
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