Abstract:
BACKGROUND:Heart valve surgery has an associated in-hospital mortality rate of 4% to 8%. This study aims to develop a simple risk model to predict the risk of in-hospital mortality for patients undergoing heart valve surgery to provide information to patients and clinicians and to facilitate institutional comparisons. METHODS AND RESULTS:Data on 32,839 patients were obtained from the Society of Cardiothoracic Surgeons of Great Britain and Ireland on patients who underwent heart valve surgery between April 1995 and March 2003. Data from the first 5 years (n=16,679) were used to develop the model; its performance was evaluated on the remaining data (n=16,160). The risk model presented here is based on the combined data. The overall in-hospital mortality was 6.4%. The risk model included, in order of importance (all P<0.01), operative priority, age, renal failure, operation sequence, ejection fraction, concomitant tricuspid valve surgery, type of valve operation, concomitant CABG surgery, body mass index, preoperative arrhythmias, diabetes, gender, and hypertension. The risk model exhibited good predictive ability (Hosmer-Lemeshow test, P=0.78) and discriminated between high- and low-risk patients reasonably well (receiver-operating characteristics curve area, 0.77). CONCLUSIONS:This is the first risk model that predicts in-hospital mortality for aortic and/or mitral heart valve patients with or without concomitant CABG. Based on a large national database of heart valve patients, this model has been evaluated successfully on patients who had valve surgery during a subsequent time period. It is simple to use, includes routinely collected variables, and provides a useful tool for patient advice and institutional comparisons.
journal_name
Circulationjournal_title
Circulationauthors
Ambler G,Omar RZ,Royston P,Kinsman R,Keogh BE,Taylor KMdoi
10.1161/CIRCULATIONAHA.104.515049subject
Has Abstractpub_date
2005-07-12 00:00:00pages
224-31issue
2eissn
0009-7322issn
1524-4539pii
CIRCULATIONAHA.104.515049journal_volume
112pub_type
杂志文章相关文献
CIRCULATION文献大全abstract:BACKGROUND:The ability of apolipoprotein (apo)A-I to induce regression of preexisting atherosclerotic lesions has not been determined, and a mouse model of atherosclerosis regression has not yet been reported. METHODS AND RESULTS:LDL receptor-deficient mice were fed a western-type diet for 5 weeks to induce atheroscle...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.cir.100.17.1816
更新日期:1999-10-26 00:00:00
abstract::The importance of pulmonary artery size and the value of a standardized pulmonary artery index (PAI) in predicting outcome after Fontan's repair have previously been reported and questioned. We retrospectively reviewed 29 patients undergoing modified Fontan repair at The Children's Hospital of Philadelphia to examine ...
journal_title:Circulation
pub_type: 杂志文章
doi:
更新日期:1989-09-01 00:00:00
abstract::Prospective data was recorded on 217 percutaneous transluminal angioplasty (PTA) procedures performed in the superficial femoral and popliteal arteries over an 8-year period. After the initial procedure, patients were followed with serial noninvasive studies and, in 71 patients, repeat angiography. The mean follow-up ...
journal_title:Circulation
pub_type: 杂志文章
doi:
更新日期:1991-02-01 00:00:00
abstract::Fifty-six patients undergoing orthotopic cardiac transplantation were given Minnesota ALG prophylactically or therapeutically for acute cardiac rejection. During a follow-up period of 0-28 months (mean follow-up period, 11.9 months), the actuarial survival for the entire group was 96% and 86% at 30 days and 1 year, re...
journal_title:Circulation
pub_type: 杂志文章
doi:
更新日期:1988-11-01 00:00:00
abstract:BACKGROUND:Current American and European guidelines emphasize the importance of rate-control treatments in treating atrial fibrillation with a Class I recommendation, although data on the survival benefits of rate control are lacking. The goal of the present study was to investigate whether patients receiving rate-cont...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/CIRCULATIONAHA.114.013709
更新日期:2015-10-27 00:00:00
abstract:BACKGROUND:To identify patients at risk for postoperative myocardial injury and death, measuring cardiac troponin routinely after noncardiac surgery has been suggested. Such monitoring was implemented in our hospital. The aim of this study was to determine the predictive value of postoperative myocardial injury, as mea...
journal_title:Circulation
pub_type: 临床试验,杂志文章
doi:10.1161/CIRCULATIONAHA.113.002128
更新日期:2013-06-11 00:00:00
abstract:BACKGROUND:Autosomal dominant hypercholesterolemia (ADH) is characterized by elevated low-density lipoprotein cholesterol levels and premature cardiovascular disease. Mutations in the genes encoding for low-density lipoprotein receptor (LDLR), apolipoprotein B (APOB), and proprotein convertase subtilisin/kexin 9 (PCSK9...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/CIRCULATIONAHA.110.979450
更新日期:2011-03-22 00:00:00
abstract:BACKGROUND:Five years ago, we described a specific ECG pattern of right bundle-branch block and ST-segment elevation in leads V1 through V3 associated with sudden death in patients without demonstrable structural heart disease. Information on long-term outcome has become available due to pooled data on a large cohort o...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.cir.97.5.457
更新日期:1998-02-10 00:00:00
abstract::To investigate the electrocardiographic and hemodynamic changes in isolated right ventricular infarction, 0.25 ml or 0.5 ml of metallic mercury was injected into the right coronary artery of 14 closed-chest dogs. At autopsy, at least 60% of the right ventricle was necrotic in every dog. Hemodynamic observations were m...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.cir.67.6.1258
更新日期:1983-06-01 00:00:00
abstract:BACKGROUND:Vascular smooth muscle cell growth factors are postulated to contribute to cardiac allograft vasculopathy (CAV). Few data quantitatively address the timing, location, or stimuli for growth factor expression and relationship to CAV. METHODS AND RESULTS:Acidic fibroblast growth factor (aFGF) mRNA expression w...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.cir.100.24.2396
更新日期:1999-12-14 00:00:00
abstract:BACKGROUND:Reducing sympathetic output to the heart from the neuraxis can protect against ventricular arrhythmias. The purpose of this study was to assess the value of thoracic epidural anesthesia (TEA) and left cardiac sympathetic denervation (LCSD) in the management of ventricular arrhythmias in patients with structu...
journal_title:Circulation
pub_type: 杂志文章,多中心研究
doi:10.1161/CIRCULATIONAHA.109.929703
更新日期:2010-06-01 00:00:00
abstract:BACKGROUND:The antiarrhythmic drugs quinidine and verapamil are known to block alpha1-adrenoceptors (alpha1ARs). Alpha1ARs are a heterogeneous family of three subtypes (alpha1A, alpha1B, and alpha1D), and little is known about the effects of quinidine and verapamil on the different human alpha1AR subtypes. METHODS AND...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.cir.97.13.1227
更新日期:1998-04-07 00:00:00
abstract:BACKGROUND:Flowing erythrocytes and platelets are separated from the luminal endothelial cell (EC) surface by a 0.5-microm-wide space named the endothelial surface layer. We hypothesized that the disruption of the endothelial surface layer by oxidized low-density lipoproteins (Ox-LDL) contributes to atherogenic increas...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.cir.101.13.1500
更新日期:2000-04-04 00:00:00
abstract:BACKGROUND:Together with pulmonary veins, many extrapulmonary vein areas may be the source of initiation and maintenance of atrial fibrillation. The left atrial appendage (LAA) is an underestimated site of initiation of atrial fibrillation. Here, we report the prevalence of triggers from the LAA and the best strategy f...
journal_title:Circulation
pub_type: 临床试验,杂志文章,多中心研究
doi:10.1161/CIRCULATIONAHA.109.928903
更新日期:2010-07-13 00:00:00
abstract:BACKGROUND:Continuous positive airway pressure (CPAP) can improve cardiac function in patients with congestive heart failure (CHF). We hypothesized that this effect might be related to CPAP-induced increases in intrathoracic pressure, which would reduce left ventricular transmural pressure (LVPtm) during systole, there...
journal_title:Circulation
pub_type: 临床试验,杂志文章
doi:10.1161/01.cir.91.6.1725
更新日期:1995-03-15 00:00:00
abstract:BACKGROUND:Anthracyclines are the most effective drugs available in the treatment of neoplastic diseases; however, they have profound consequences on the structure and function of the heart, which over time cause a cardiomyopathy that leads to congestive heart failure. METHODS AND RESULTS:Administration of doxorubicin...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/CIRCULATIONAHA.109.895771
更新日期:2010-01-19 00:00:00
abstract:BACKGROUND:In patients with atrial fibrillation, intracardiac atrial defibrillation causes discomfort. An easily applicable, short-acting analgesic and anxiolytic drug would increase acceptability of this new treatment mode. METHODS AND RESULTS:In a double-blind, placebo-controlled manner, the effect of intranasal but...
journal_title:Circulation
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1161/01.cir.99.14.1837
更新日期:1999-04-13 00:00:00
abstract:BACKGROUND:The metabolic syndrome is associated with increased angiotensin II activity, induction of a proinflammatory and oxidative state, and endothelial dysfunction. We evaluated the ability of irbesartan, an angiotensin receptor blocker, and lipoic acid, an antioxidant, to affect endothelial function and inflammati...
journal_title:Circulation
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1161/01.CIR.0000153272.48711.B9
更新日期:2005-01-25 00:00:00
abstract:BACKGROUND:Systemic markers of inflammation have been found in unstable angina. Disruption of culprit coronary stenoses may cause a greater inflammatory response in patients with unstable than those with stable angina. We assessed the time course of C-reactive protein (CRP), serum amyloid A protein (SAA), and interleuk...
journal_title:Circulation
pub_type: 临床试验,杂志文章
doi:10.1161/01.cir.98.22.2370
更新日期:1998-12-01 00:00:00
abstract::The echographic isovolumic contraction time (ICT) of the left ventricle (LV) was measured in order to assess alterations of LV performance in children with various forms of cardiac disease. The echographic ICT was defined as the interval between coaptation of the anterior and posterior mitral valve leaflets and aortic...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.cir.54.5.751
更新日期:1976-11-01 00:00:00
abstract:BACKGROUND:Despite successful restoration of epicardial vessel patency with primary percutaneous coronary intervention, coronary microvascular injury occurs in a large proportion of patients with ST-segment-elevation myocardial infarction, adversely affecting clinical and functional outcome. Ticagrelor has been reporte...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/CIRCULATIONAHA.118.035931
更新日期:2019-01-29 00:00:00
abstract:BACKGROUND:Inhaled nitric oxide (iNO) has been used to assess the vasodilator capacity of the pulmonary vascular bed in children with congenital heart disease and elevated pulmonary vascular resistance. Inhaled iloprost is a pulmonary vasodilator for the long-term treatment of pulmonary hypertension (PHT). Because thes...
journal_title:Circulation
pub_type: 临床试验,杂志文章
doi:10.1161/01.cir.103.4.544
更新日期:2001-01-30 00:00:00
abstract:BACKGROUND:The possible contribution of endothelin-1, a potent endothelium-derived vasoconstrictor peptide, to neurohumoral compensation for hemodynamic stress was examined in nine normal volunteers and six patients with severe congestive heart failure. METHODS AND RESULTS:Plasma levels of endothelin-1 were measured w...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.cir.85.2.510
更新日期:1992-02-01 00:00:00
abstract::Exogenous adenosine has been shown to have potent electrophysiologic effects and antiarrhythmic properties within the atrioventricular (AV) node. Endogenous adenosine, a nucleoside with an increased release signaled by ischemia and hypoxia, is not believed to exert significant effects during homeostatic conditions. Re...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.cir.80.6.1536
更新日期:1989-12-01 00:00:00
abstract:BACKGROUND:Age is a predictor of cognitive dysfunction after cardiac surgery, but the mechanism is unknown. The purpose of our study was to determine whether age-related decrements in cognition are associated with cerebral blood flow (CBF) autoregulation during cardiopulmonary bypass (CPB). METHODS AND RESULTS:Cogniti...
journal_title:Circulation
pub_type: 临床试验,杂志文章
doi:
更新日期:1994-11-01 00:00:00
abstract:BACKGROUND:Early childhood introduction of nutritional habits aimed at atherosclerosis prevention reduces children's serum total cholesterol concentration, but its effect on vascular endothelial function is unknown. METHODS AND RESULTS:Between 1990 and 1992, we randomized healthy 7-month-old infants (n=1062) to interv...
journal_title:Circulation
pub_type: 杂志文章,随机对照试验
doi:10.1161/CIRCULATIONAHA.105.583195
更新日期:2005-12-13 00:00:00
abstract::Blood pressure and heart rate of 15 male shift workers were measured every 15 minutes for 24 hours during three work shifts: morning, 4:00 AM to noon; afternoon, noon to 8:00 PM; and night, 8:00 PM to 4:00 AM. For each shift, 24-hour systolic and diastolic blood pressure showed a large "trough" (the low pressure span)...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.cir.80.2.341
更新日期:1989-08-01 00:00:00
abstract::High-density lipoprotein (HDL) cholesterol distributions were compared among 191 black and 1341 white males and 233 black and 1088 white females, ages 5-44 years, examined in five of the Lipid Research Clinic (LRC) population-based surveys. Mean HDL cholesterol was higher in blacks than whites in each 5-year age group...
journal_title:Circulation
pub_type: 杂志文章
doi:
更新日期:1980-11-01 00:00:00
abstract:BACKGROUND:The extent of microvascular obstruction during acute coronary occlusion may determine the eventual magnitude of myocardial damage and thus, patient prognosis after infarction. By contrast-enhanced MRI, regions of profound microvascular obstruction at the infarct core are hypoenhanced and correspond to greate...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.cir.97.8.765
更新日期:1998-03-03 00:00:00
abstract::Cerebral and retinal ischemic events have been described in mitral valve prolapse. To determine whether platelets play a part in the pathogenesis of thromboembolism we studied 29 patients with mitral valve prolapse, including nine (group I) with thromboembolism (cerebral, retinal and deep venous), eight (group II) wit...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.cir.63.3.552
更新日期:1981-03-01 00:00:00