Frequency and risk factors of adverse cardiovascular events in
patients awaiting cardiac surgery

    Authors

    Keywords

    cardiac surgery, waiting list, risk factors

    DOI

    https://doi.org/10.15836/ccar2018.317

    Full Text

    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.

    Cardiologia Croatica
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    Frequency and risk factors of adverse cardiovascular events in
patients awaiting cardiac surgery

    Extended Abstract
    Issue11-12
    Published
    Pages317
    PDF via DOIhttps://doi.org/10.15836/ccar2018.317
    cardiac surgery
    waiting list
    risk factors

    Authors

    Tomislav Letilović*ORCIDUniversity Hospital “Merkur”, Zagreb, Croatia
    Luka PerčinORCIDUniversity Hospital “Merkur”, Zagreb, Croatia
    Vedran RadonićORCIDUniversity Hospital “Merkur”, Zagreb, Croatia
    Goran KurdijaORCIDUniversity Hospital “Merkur”, Zagreb, Croatia
    Damir KozmarORCIDUniversity Hospital “Merkur”, Zagreb, Croatia
    Darko PočanićORCIDUniversity Hospital “Merkur”, Zagreb, Croatia
    Mario StipinovićUniversity Hospital “Merkur”, Zagreb, Croatia
    Ivana JurinORCIDUniversity Hospital “Merkur”, Zagreb, Croatia
    Hrvoje GašparovićORCIDUniversity Hospital “Merkur”, Zagreb, Croatia
    Helena JerkićORCIDUniversity Hospital “Merkur”, Zagreb, Croatia

    Full Text

    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.