Authors

• Tomislav Letilović — Klinička bolnica Merkur, Zagreb, Hrvatska — ORCID: 0000-0003-1229-7983
• Luka Perčin — Dom zdravlja Primorsko-goranske županije, Rijeka, Hrvatska — ORCID: 0000-0003-0497-6871
• Vedran Radonić — Klinička bolnica Merkur, Zagreb, Hrvatska — ORCID: 0000-0002-2115-2826
• Goran Kurdija — Medicinski fakultet Sveučilišta u Zagrebu, Zagreb, Hrvatska — ORCID: 0000-0002-4407-4824
• Damir Kozmar — Klinička bolnica Merkur, Zagreb, Hrvatska — ORCID: 0000-0001-7626-3534
• Darko Počanić — Klinička bolnica Merkur, Zagreb, Hrvatska — ORCID: 0000-0003-3257-110X
• Mario Stipinović — Klinička bolnica Merkur, Zagreb, Hrvatska
• Ivana Jurin — Klinička bolnica Dubrava, Zagreb, Hrvatska — ORCID: 0000-0002-2637-9691
• Hrvoje Gašparović — Medicinski fakultet Sveučilišta u Zagrebu, Zagreb, Hrvatska — ORCID: 0000-0002-2492-3702
• Helena Jerkić — Klinička bolnica Merkur, Zagreb, Hrvatska — ORCID: 0000-0002-1650-4735

Abstract

**Introduction**: Most of the patients scheduled for cardiac surgery spend certain amount of time on the waiting list. Previous studies have shown that those patients have a risk of new major adverse cardiovascular events (MACE) while awaiting surgery. (1, 2) The first goal of this study was to determine the frequency of occurrence of MACE in patients awaiting cardiac surgery after being invasively assessed at the Department of Cardiology of University Hospital “Merkur”. Furthermore, we tried to find association of various clinical characteristics and higher degree of MACE. **Patients and Methods**: Data were collected from patients presented at out heart team meetings in the period from March 2013 to the end of 2016. Relevant clinical characteristics, of patients regarded as good cardiac surgery candidates, were gathered from central hospital system. Information regarding MACE were collected via telephone contact with a patient or its family and through examining medical documentation if it was available MACE was defined as either death, stroke, myocardial infarction or heart failure. **Results**: We gathered data from 333 patients. Mean follow-up time, defined as a time to surgery or to MACE, was 238.51 days (range 3 do 1269 days). There were 33 (9.9%) adverse events. From various clinical parameters that were tested only previous stroke (p=0.002; HR 1.77-13.23) and diabetes (p=0.036; HR 1.06-5.69) were independently associated with higher rate of MACE. Previous myocardial infarction showed a marginal association with higher rate of MACE (p=0.05; HR 0.99-6.37). None of the other relevant clinical data, including the data on the extent of the coronary disease or/and associated valvular pathology was found to be related to occurrence of MACE. **Conclusion**: In patients awaiting cardiac surgery one can expect adverse cardiovascular events to occur. Previous stroke, diabetes and to some extent previous myocardial infarction were found to be related to higher degree of such events.

Keywords

cardiac surgery, waiting list, risk factors

DOI

Literature

1. Seddon ME, French JK, Amos DJ, Ramanathan K, McLaughlin SC, White HD. Waiting times and prioritization for coronary artery bypass surgery in New Zealand. Heart. 1999 Jun;81(6):586–92. https://doi.org/10.1136/hrt.81.6.586
2. Ray AA, Buth KJ, Sullivan JA, Johnstone DE, Hirsch GM. Waiting for Cardiac Surgery Results of a Risk-Stratified Queuing Process. Circulation. 2001 Sep 18;104(12) Suppl 1:I92–8. https://doi.org/10.1161/hc37t1.094904