Abstract:
OBJECTIVE:Previous studies comparing off-pump coronary artery bypass surgery (OPCABG) to conventional techniques utilizing cardiopulmonary bypass (CABG-CPB) have failed to provide patient selection guidelines. We sought to determine guidelines, attempting to rectify the limitations of previous studies. METHODS AND RESULTS:A retrospective analysis of prospectively collected data from the Society of Thoracic Surgeons National Database, from January 1999 through December 2000, identified 204 602 multivessel coronary artery bypass (CABG) patients. Unadjusted and risk-adjusted odds ratios (OR) were calculated to compare OPCABG and CABG-CPB morbidity and mortality. A propensity model was developed to identify factors associated with selection for OPCABG. All off-pump patients were pair-matched with on-pump patients based on their propensity to receive an off-pump procedure. Off-pump patients, 8.8% of the total, had significantly different patient characteristics than the on-pump group. Characteristics associated with OPCABG selection included fewer diseased vessels, absence of left main disease, fewer bypass grafts, no previous CABG, older age, chronic lung disease, and renal failure. Unadjusted and risk-adjusted odds ratios indicate a significant off-pump survival benefit and decreased morbidity including stroke and renal failure in the overall group. Propensity matching also showed a significant OPCABG survival benefit [OR (95% CI) 0.83 (0.72, 0.96)]. Subgroup analysis of propensity-matched groups identified off-pump survival benefits in patients with previous CABG (OR=0.53), diabetics (OR=0.66), LVEF between 30% to 50% (OR=0.75), females (OR=0.79), and age 66 to 75 years (OR=0.80). CONCLUSIONS:OPCABG imparts some survival benefit to most patient subgroups. Higher risk patients including those undergoing reoperative CABG, diabetics, and the elderly may gain the most benefit.
journal_name
Circulationjournal_title
Circulationauthors
Magee MJ,Coombs LP,Peterson ED,Mack MJdoi
10.1161/01.cir.0000089187.51855.77subject
Has Abstractpub_date
2003-09-09 00:00:00pages
II9-14eissn
0009-7322issn
1524-4539pii
108/10_suppl_1/II-9journal_volume
108 Suppl 1pub_type
杂志文章相关文献
CIRCULATION文献大全abstract:BACKGROUND:CXCL16/SR-PSOX is an interferon-gamma-regulated chemokine and scavenger receptor for oxidized low-density lipoprotein that is expressed in atherosclerotic lesions. Proteolytic cleavage of membrane-bound CXCL16 releases soluble CXCL16, which may promote migration of effector T cells and augment a proatherogen...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/CIRCULATIONAHA.108.806877
更新日期:2009-06-30 00:00:00
abstract::Disorders associated with the overproduction or delayed clearance of beta-very low density lipoprotein and low density lipoprotein (LDL) are strikingly related to premature coronary artery disease. There are five recognized classes of LDL-lowering drugs, each acting through different basic mechanisms. The increased pr...
journal_title:Circulation
pub_type: 杂志文章,评审
doi:
更新日期:1993-04-01 00:00:00
abstract:BACKGROUND:Cardiac tamponade is associated with fatal outcomes for patients with acute type A aortic dissection, and the presence of cardiac tamponade should prompt urgent aortic repair. However, treatment of the patient with critical cardiac tamponade who cannot survive until surgery remains unclear. We analyzed our e...
journal_title:Circulation
pub_type: 临床试验,杂志文章,多中心研究
doi:10.1161/CIRCULATIONAHA.111.082685
更新日期:2012-09-11 00:00:00
abstract:BACKGROUND:We examined the relationship between hypertension subtype and cardiovascular disease incidence and mortality in Chinese adults. METHODS AND RESULTS:We conducted a prospective cohort study in a nationally representative sample of 169 871 Chinese men and women aged >or=40 years. Data on systolic (SBP) and dia...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/CIRCULATIONAHA.107.723593
更新日期:2008-10-07 00:00:00
abstract:BACKGROUND:The cyclin-dependent kinase inhibitors (CKIs) have different patterns of expression in vascular diseases. The Kip/Cip CKIs, p27(Kip1) and p21(Cip1), are upregulated during arterial repair and negatively regulate the growth of vascular smooth muscle cells (VSMCs). In contrast, the Ink CKI, p16(Ink4), is not e...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.cir.101.17.2022
更新日期:2000-05-02 00:00:00
abstract:BACKGROUND:Angiotensin II (Ang II) plays a critical role in the development of vascular lesions in hypertension, atherosclerosis, and several renal diseases. Because Ang II may contribute to the leukocyte recruitment associated with these pathological states, the aim of the present study was to assess the role of Ang I...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.cir.102.17.2118
更新日期:2000-10-24 00:00:00
abstract::The formula for survival in resuscitation describes educational efficiency and local implementation as key determinants in survival after cardiac arrest. Current educational offerings in the form of standardized online and face-to-face courses are falling short, with providers demonstrating a decay of skills over time...
journal_title:Circulation
pub_type: 共识发展会议,杂志文章,评审
doi:10.1161/CIR.0000000000000583
更新日期:2018-08-07 00:00:00
abstract::The goals of electrocardiographic (ECG) monitoring in hospital settings have expanded from simple heart rate and basic rhythm determination to the diagnosis of complex arrhythmias, myocardial ischemia, and prolonged QT interval. Whereas computerized arrhythmia analysis is automatic in cardiac monitoring systems, compu...
journal_title:Circulation
pub_type: 指南,杂志文章,实务指引
doi:10.1161/01.CIR.0000145144.56673.59
更新日期:2004-10-26 00:00:00
abstract:BACKGROUND:In heart failure (HF), aldosterone has been implicated in the formation of reactive interstitial fibrosis, a maladaptation that contributes to left ventricular (LV) remodeling. Eplerenone is a novel selective aldosterone blocker. The present study examined the effects of long-term monotherapy with eplerenone...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.cir.0000039104.56479.42
更新日期:2002-12-03 00:00:00
abstract:BACKGROUND:Despite improvements in management, infective endocarditis remains associated with high mortality and morbidity. We describe temporal changes in the incidence, microbiology, and outcomes of infective endocarditis and the effect of changes in national antibiotic prophylaxis guidelines on incident infective en...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/CIRCULATIONAHA.119.044913
更新日期:2020-06-23 00:00:00
abstract::Patients with idiopathic hypertrophic subaortic stenosis (IHSS) have supernormal left ventricular systolic function at rest. Septal myotomy/myectomy reduces outflow obstruction and symptoms. However, it has been proposed that operation causes myocardial damage, with consequent reduction in left ventricular function an...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.cir.60.2.82
更新日期:1979-08-01 00:00:00
abstract:BACKGROUND:Nuclear reprogramming provides an emerging strategy to produce embryo-independent pluripotent stem cells from somatic tissue. Induced pluripotent stem cells (iPS) demonstrate aptitude for de novo cardiac differentiation, yet their potential for heart disease therapy has not been tested. METHODS AND RESULTS:...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/CIRCULATIONAHA.109.865154
更新日期:2009-08-04 00:00:00
abstract:BACKGROUND:Plaque rupture with subsequent thrombosis is recognized as the underlying pathophysiology of most acute coronary syndromes and stroke. Thus, direct thrombus visualization may be beneficial for both diagnosis and guidance of therapy. We sought to test the feasibility of direct imaging of acute and subacute th...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.CIR.0000127034.50006.C0
更新日期:2004-04-27 00:00:00
abstract:BACKGROUND:This study was performed to determine whether chronic cocaine abuse is associated with left ventricular hypertrophy in humans. METHODS AND RESULTS:A consecutive series of 40 chronic cocaine abusers 23-44 years old who were enrolled in an inpatient drug rehabilitation program were considered for the study. S...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.cir.84.3.1130
更新日期:1991-09-01 00:00:00
abstract:BACKGROUND:Physical activity is associated with lower risk of cardiovascular disease, but the mechanisms are uncertain. Hemostatic and inflammatory markers have been linked with risk of cardiovascular disease. We therefore examined the relationship between physical activity and hemostatic and inflammatory variables. M...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/hc1502.107117
更新日期:2002-04-16 00:00:00
abstract:BACKGROUND:Right ventricular (RV) function is the major determinant for both functional capacity and survival in patients with pulmonary arterial hypertension (PAH). Despite the recognized clinical importance of preserving RV function, the subcellular mechanisms that govern the transition from a compensated to a decomp...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/CIRCULATIONAHA.120.047626
更新日期:2020-10-13 00:00:00
abstract:BACKGROUND:Timely primary percutaneous coronary intervention (PPCI) cannot be offered to all patients with ST-segment-elevation myocardial infarction (STEMI). Pharmaco-invasive (PhI) strategy has been proposed as a valuable alternative for eligible patients with STEMI. We conducted a randomized study to compare the eff...
journal_title:Circulation
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1161/CIRCULATIONAHA.117.030582
更新日期:2017-10-17 00:00:00
abstract::Labetalol was administered to six hypertensive subjects in increasing doses for seven days. A decrease in both supine and standing arterial pressure and heart rate was observed with no change in cardiac output and few side effects. Exercise tolerance was unaltered by the drug, but the heart rate and arterial pressure ...
journal_title:Circulation
pub_type: 临床试验,杂志文章
doi:10.1161/01.cir.55.2.370
更新日期:1977-02-01 00:00:00
abstract:BACKGROUND:Myocardial perfusion reflects the macro- and microvascular coronary circulation. Recent quantitation developments using cardiovascular magnetic resonance perfusion permit automated measurement clinically. We explored the prognostic significance of stress myocardial blood flow (MBF) and myocardial perfusion r...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/CIRCULATIONAHA.119.044666
更新日期:2020-04-21 00:00:00
abstract:BACKGROUND:MRI of specific components in atherosclerotic plaque may provide information on plaque stability and its potential to rupture. We evaluated gadofluorine in atherosclerotic rabbits using a new MR sequence that allows plaque detection within 1 hour after injection and assessed enhancement in lipid-rich and non...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.CIR.0000129310.17277.E7
更新日期:2004-06-15 00:00:00
abstract:BACKGROUND:Recombinant staphylokinase (STAR) was shown recently to offer promise for coronary arterial thrombolysis in patients with evolving myocardial infarction. The present multicenter randomized open trial was designed to assess the thrombolytic efficacy, safety, and fibrin specificity of STAR relative to accelera...
journal_title:Circulation
pub_type: 临床试验,杂志文章,多中心研究,随机对照试验
doi:10.1161/01.cir.92.8.2044
更新日期:1995-10-15 00:00:00
abstract:BACKGROUND:Long-term rapid atrial pacing may result in atrial fibrillation (AF) in dogs. Whether there is histological evidence for neural remodeling is unclear. METHOD AND RESULTS:We performed rapid right atrial pacing in 6 dogs for 111+/-76 days to induce sustained AF. Tissues from 6 healthy dogs were used as contro...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.cir.103.1.22
更新日期:2001-01-02 00:00:00
abstract:BACKGROUND:Myocardial infarction (MI) is an ischemic wound that recruits millions of leukocytes. MI-associated blood leukocytosis correlates inversely with patient survival, yet the signals driving heightened leukocyte production after MI remain incompletely understood. METHODS AND RESULTS:With the use of parabiosis s...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/CIRCULATIONAHA.115.016160
更新日期:2015-11-17 00:00:00
abstract:BACKGROUND:The positions, sizes, and shapes of ventricular septal defects (VSDs) can be difficult to assess by 2-dimensional echocardiography (2DE). Volume-rendered 3-dimensional echocardiography (3DE) can provide unique views of VSDs from the left ventricular (LV) side, allowing complete assessment of their circumfere...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.cir.98.13.1307
更新日期:1998-09-29 00:00:00
abstract::To study the variability of the fraction of CPK released from the infarcted heart which enters the serum (serum entry ratio, or SER) with size and model of infarction, nine dogs underwent homogeneous infarctions (LAD ligation) of varying sizes, and 10 dogs underwent scattered infarctions (left coronary embolization). ...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.cir.58.6.1143
更新日期:1978-12-01 00:00:00
abstract::Two-dimensional echocardiography can provide serial cross-sectional images of the left ventricular cavity. We examined whether such serial images from steady-state ejecting hearts would allow three-dimensional reconstruction and accurate volume estimation without major geometric assumptions. Cross-circulated, paced do...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.cir.60.2.320
更新日期:1979-08-01 00:00:00
abstract:BACKGROUND:Smoking cessation is a key component of secondary cardiovascular disease prevention. Varenicline, a partial alpha4beta2 nicotinic acetylcholine receptor agonist, is effective for smoking cessation in healthy smokers, but its efficacy and safety in smokers with cardiovascular disease are unknown. METHODS AND...
journal_title:Circulation
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1161/CIRCULATIONAHA.109.869008
更新日期:2010-01-19 00:00:00
abstract::Proarrhythmic effects of flecainide acetate have been reported during exercise, but the mechanism for the arrhythmogenic interaction between flecainide and exercise is unknown. We hypothesized that the sinus tachycardia of exercise may enhance flecainide-induced conduction slowing by increasing use-dependent sodium ch...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.cir.79.5.1000
更新日期:1989-05-01 00:00:00
abstract::Congestive heart failure is often preceded by a latent or preclinical phase in which patients are relatively asymptomatic. During this period, there is neuroendocrine activation, left ventricular dysfunction, and remodeling of the heart. The extent to which these activities are interrelated is unclear, but it appears ...
journal_title:Circulation
pub_type: 杂志文章,评审
doi:
更新日期:1993-05-01 00:00:00
abstract::A significant fraction of patients in whom mechanical left ventricular assist devices are implanted for refractory cardiac failure after open heart surgery have had the complication of right heart failure. To evaluate the effects of left ventricular assistance and pressure unloading on right ventricular function, we p...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.cir.70.4.708
更新日期:1984-10-01 00:00:00