Coronary revascularization induces a shift from cardiac toward noncardiac mortality without improving survival in vascular surgery patients

Journal of Vascular Surgery
Klaas H J UlteeHence J M Verhagen

Abstract

Although evidence has shown that ischemic heart disease (IHD) in vascular surgery patients has a negative impact on the prognosis after surgery, it is unclear whether directed treatment of IHD may influence cause-specific and overall mortality. The objective of this study was to determine the prognostic implication of coronary revascularization (CR) on overall and cause-specific mortality in vascular surgery patients. Patients undergoing surgery for abdominal aortic aneurysm, carotid artery stenosis, or peripheral artery disease in a university hospital in The Netherlands between January 2003 and December 2011 were retrospectively included. Survival estimates were obtained by Kaplan-Meier and Cox regression analysis. A total of 1104 patients were included. Adjusted survival analyses showed that IHD significantly increased the risk of overall mortality (hazard ratio [HR], 1.50; 95% confidence interval, 1.21-1.87) and cardiovascular death (HR, 1.93; 95% confidence interval, 1.35-2.76). Compared with those without CR, patients previously undergoing CR had similar overall mortality (HR, 1.38 vs 1.62; P = .274) and cardiovascular mortality (HR, 1.83 vs 2.02; P = .656). Nonrevascularized IHD patients were more likely to die of IHD (6...Continue Reading

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Citations

Aug 20, 2016·Netherlands Heart Journal : Monthly Journal of the Netherlands Society of Cardiology and the Netherlands Heart Foundation·T RahatF Latif
Jan 22, 2018·Current Cardiology Reports·Thomas F Whayne, Sibu P Saha
Mar 12, 2016·International Anesthesiology Clinics·Dallas Duncan, Duminda N Wijeysundera
Aug 7, 2018·Health Affairs·Jonathan D CampbellAndrew H Briggs
Sep 17, 2021·Angiologii︠a︡ i sosudistai︠a︡ khirurgii︠a︡ = Angiology and vascular surgery·L N IvanovD Iu Chukrin

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