Dataset Information

Mid-term outcomes of patients with subclinical hypothyroidism after coronary bypass surgery.

ABSTRACT:

Objectives

Subclinical hypothyroidism (SCH) is characterized by an elevated thyroid-stimulating hormone and normal free thyroxine. This study aimed to evaluate the influence of SCH on mid-term outcomes of patients after coronary artery bypass grafting (CABG).

Methods

From January 2015 to December 2018, 548 SCH patients and 6718 euthyroid patients who underwent CABG were identified. Propensity score matching was used to create 2 cohorts with similar baseline characteristics (n = 544 in each group). The mid-term follow-up outcomes were compared. Adjusted hazard ratios (HRs) were calculated using Cox proportional hazards models.

Results

The mean follow-up for all patients was 39.7 ± 17.3 months. The unadjusted Kaplan-Meier estimate for mortality at 5-year follow-up was higher in patients with SCH compared with euthyroid patients (5.3% vs 1.6%, log-rank P = 0.03). After adjusting for covariates, the risk of mortality was higher in patients with SCH compared with euthyroid patients [HR, 2.40; 95% confidence interval (CI), 1.03-5.58; P = 0.04]. The adjusted risk of major adverse cardiovascular and cerebral event (HR, 2.16; 95% CI, 1.51-3.08; P < 0.001) and angina (HR, 2.44; 95% CI, 1.41-4.24; P = 0.001) was higher in patients with SCH compared with euthyroid patients.

Conclusions

SCH is associated with an increased risk of mortality, major adverse cardiovascular and cerebral event and angina compared with euthyroidism in patients undergoing CABG.

SUBMITTER: Zhao D

PROVIDER: S-EPMC10401495 | biostudies-literature | 2023 Aug

REPOSITORIES: biostudies-literature

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Publications

Mid-term outcomes of patients with subclinical hypothyroidism after coronary bypass surgery.

Zhao Dong D Zhao Wei W Wang Chuangshi C Xu Fei F Zhao Wei W Tiemuerniyazi Xieraili X Ma Hao H Feng Wei W

Interdisciplinary cardiovascular and thoracic surgery 20230801 2

<h4>Objectives</h4>Subclinical hypothyroidism (SCH) is characterized by an elevated thyroid-stimulating hormone and normal free thyroxine. This study aimed to evaluate the influence of SCH on mid-term outcomes of patients after coronary artery bypass grafting (CABG).<h4>Methods</h4>From January 2015 to December 2018, 548 SCH patients and 6718 euthyroid patients who underwent CABG were identified. Propensity score matching was used to create 2 cohorts with similar baseline characteristics (n = 54 ...[more]

PMID: 37522881

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Project description:BackgroundWe evaluated the mid-term outcomes and angiographic patency of redo coronary artery bypass grafting (CABG).MethodsOf 2,851 patients who underwent isolated CABG at Seoul National University Hospital from 2000 to 2017, 88 underwent redo CABG. Patients' mean age at redo CABG was 66.0±8.0 years. The mean interval between the first-time and redo CABG was 113.0±62.4 months. The mean follow-up duration was 86 months. Early and mid-term clinical outcomes were evaluated. Angiographic patency rates were evaluated early (1-2 days), 1 year, and 5 years after surgery. Comparative analyses between on-pump and off-pump CABG were also performed.ResultsThe culprits for reoperation were previous grafts (65.6%), native coronary vessels (17.8%), and both (16.7%). Off-pump CABG was performed in 75 cases (85.2%), and the mean number of distal anastomoses was 1.8±0.8. The saphenous vein (39.7%) was used most frequently, followed by the right internal thoracic artery (28.4%), right gastroepiploic artery (21.3%), left internal thoracic artery (7.8%), and radial artery (2.8%). Operative mortality was 1.1%. The overall survival, cumulative incidence of cardiac death, and cumulative incidence of major adverse cardiac events were 71.3%,12.0%, and 23.3% at 5 years after surgery, respectively. The overall angiographic patency rates were 95.7%, 90.1%, and 92.2% on early, 1-year, and 5-year angiograms, respectively. The angiographic patency rates of saphenous vein grafts were 93.1%, 85.6%, and 91.3% on early, 1-year, and 5-year angiograms, respectively. No significant differences in clinical outcomes or angiographic patency rates were observed between the on-pump (n=13) versus off-pump (n=75) groups. Multivariable analysis revealed that age (hazard ratio [HR], 1.07; p=0.005) and chronic kidney disease (HR, 3.85; p=0.001) were risk factors for all-cause mortality.ConclusionRedo CABG could mostly be performed using the off-pump technique and did not show increased operative mortality and morbidities.

Project description:BackgroundPatients with schizophrenia spectrum disorder have increased risk of coronary artery disease.AimsTo investigate long-term outcomes of patients with schizophrenia spectrum disorder and coronary artery disease after coronary artery bypass grafting surgery (CABG).MethodData from patients with schizophrenia spectrum disorder (n = 126) were retrospectively compared with propensity-matched (1:20) control patients without schizophrenia spectrum disorder (n = 2520) in a multicentre study in Finland. All patients were treated with CABG. The median follow-up was 7.1 years. The primary outcome was all-cause mortality.ResultsPatients with diagnosed schizophrenia spectrum disorder had an elevated risk of 10-year mortality after CABG, compared with control patients (42.7 v. 30.3%; hazard ratio 1.56; 95% CI 1.13-2.17; P = 0.008). Schizophrenia spectrum diagnosis was associated with a higher risk of major adverse cardiovascular events during follow-up (49.9 v. 32.6%, subdistribution hazard ratio 1.59; 95% CI 1.18-2.15; P = 0.003). Myocardial infarction (subdistribution hazard ratio 1.86; P = 0.003) and cardiovascular mortality (subdistribution hazard ratio 1.65; P = 0.017) were more frequent in patients with versus those without schizophrenia spectrum disorder, but there was no difference for stroke. Psychiatric ward admission, antipsychotic medication, antidepressant use and benzodiazepine use before CABG were not associated with outcome differences. After CABG, patients with schizophrenia spectrum disorder received statin therapy less often and had lower doses; the use of other cardiovascular medications was similar between schizophrenia spectrum and control groups.ConclusionsPatients with schizophrenia spectrum disorder have higher long-term risks of death and major adverse cardiovascular events after CABG. The results underline the vulnerability of these patients and highlight the importance of intensive secondary prevention and risk factor optimisation.

Dataset Information

Mid-term outcomes of patients with subclinical hypothyroidism after coronary bypass surgery.

Objectives

Methods

Results

Conclusions

Publications

Mid-term outcomes of patients with subclinical hypothyroidism after coronary bypass surgery.

Similar Datasets

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