Impact of South Asian Ethnicity on Long-Term Outcomes After Coronary Artery Bypass Grafting Surgery: A Large Population-Based Propensity Matched Study Cardiovascular Surgery

Background Ethnicity is an important predictor of coronary artery bypass graft surgery (CABG) outcomes. South Asians (SA), one of the largest ethnic groups with a high burden of cardiovascular disease, are hypothesized to have inferior outcomes after CABG compared to other ethnic groups. Given the paucity and controversy of literature in this area, the objective of this study was to examine the impact of SA versus the general population (GP) on long-term outcomes following CABG. Method and Results Using administrative databases and a surname algorithm, 83 850 patients (SA: 2653, GP: 81 197) who underwent isolated CABG in Ontario, Canada from 1996 to 2007 were identified; mean follow-up was 9.1±3.9 years. SA were younger (SA: 61.7±9.4, GP: 64.1±10.0 years, standardized difference=0.25) with more cardiac risk factors, including diabetes (SA: 54.1%, GP: 34.9%, standardized difference =0.40). Propensity-score matching resulted in 2473 matched pairs between SA and GP with all baseline covariates being balanced (standardized difference
Source: JAHA:Journal of the American Heart Association - Category: Cardiology Authors: Tags: Clinical Studies, Race and Ethnicity, Cardiovascular Surgery, Revascularization, Mortality/Survival Source Type: research

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AbstractPurpose of ReviewTo review the clinical evidence on the use of percutaneous coronary intervention (PCI) revascularization options in left main (LM) disease in comparison with coronary artery bypass graft (CABG). Coronary artery disease (CAD) involving the LM is associated with high morbidity and mortality. Though CABG remains the gold standard for complex CAD involving the LM artery, recent trials have shown a trend towards non-inferiority of the LM PCI when compared with CABG in certain subset of patients.Recent FindingsTwo recent major randomized trials compared the outcomes of PCI versus CABG in the LM and multi...
Source: Current Cardiology Reports - Category: Cardiology Source Type: research
Conclusion Among diabetic patients with MVD, the long-term outcomes of PCI versus CABG differed according to clinical presentation. CABG may be more beneficial for NSTE-ACS patients with MVD in reducing MACCE and MI, whereas PCI was as effective as CABG for SCAD patients with MVD. Therefore, clinical presentation must be considered when choosing revascularization strategies in these patients.
Source: Coronary Artery Disease - Category: Cardiology Tags: CAD in Diabetics Source Type: research
Publication date: Available online 1 September 2019Source: The LancetAuthor(s): Deepak L Bhatt, Philippe Gabriel Steg, Shamir R Mehta, Lawrence A Leiter, Tabassome Simon, Kim Fox, Claes Held, Marielle Andersson, Anders Himmelmann, Wilhelm Ridderstråle, Jersey Chen, Yang Song, Rafael Diaz, Shinya Goto, Stefan K James, Kausik K Ray, Alexander N Parkhomenko, Mikhail N Kosiborod, Darren K McGuire, Robert A HarringtonSummaryBackgroundPatients with stable coronary artery disease and diabetes with previous percutaneous coronary intervention (PCI), particularly those with previous stenting, are at high risk of ischaemic even...
Source: The Lancet - Category: General Medicine Source Type: research
Authors: Wang TKM, Liao YB, Choi D, Harmos S, Haydcok D, Gerber I Abstract AIMS: A significant minority of patients undergoing mitral valve surgery (MVR) have indication for coronary artery bypass grafting (CABG). The risks of combination surgeries are not well appreciated and maybe more than additive. We compared the characteristics and outcomes of MVR+/-CABG performed at our centre. METHODS: Consecutive patients undergoing isolated MVR or with concurrent (MVR+)CABG at Auckland City Hospital during 2005-2012 were compared for baseline and operative characteristics and outcomes in univariable and multivariable ...
Source: New Zealand Medical Journal - Category: General Medicine Tags: N Z Med J Source Type: research
ConclusionsA distance greater than 16  km was associated with increased probability of non-attendance at exCR, as were smoking, a higher burden of comorbidities, and male sex. A better understanding of individual and structural factors can support the development of future rehabilitation services.
Source: BMC Sports Science, Medicine and Rehabilitation - Category: Sports Medicine Source Type: research
This study sought to investigate what could be learned from how these men have fared. The men were born in 1925-1928 and similar health-related data from questionnaires, physical examination, and blood samples are available for all surveys. Survival curves over various variable strata were applied to evaluate the impact of individual risk factors and combinations of risk factors on all-cause deaths. At the end of 2018, 118 (16.0%) of the men had reached 90 years of age. Smoking in 1974 was the strongest single risk factor associated with survival, with observed percentages of men reaching 90 years being 26.3, 25.7, ...
Source: Fight Aging! - Category: Research Authors: Tags: Newsletters Source Type: blogs
Authors: Faggiano P, Fattirolli F, Frisinghelli A, Piccioli L, Dasseni N, Silverii MV, Albricci L, D'Ambrosio G, Garrì R, Esposito L, Giallauria F Abstract The present study aims at evaluating the achievement of blood pressure, lipid and blood glucose targets, healthy lifestyle changes and appropriate drug prescription/adherence in patients attending secondary prevention/CR ambulatory visit after index cardiovascular event in a time period ranging 1 to 5 year. At ambulatory visit, a predetermined set of data collection was used, including demographic data, cardiovascular risk factors and lifestyle habits, ty...
Source: Monaldi Archives for Chest Disease - Category: Respiratory Medicine Tags: Monaldi Arch Chest Dis Source Type: research
Publication date: Available online 27 March 2019Source: The Lancet Diabetes &EndocrinologyAuthor(s): Ravi Retnakaran, Baiju R ShahSummaryBackgroundIn studies to date, gestational diabetes has consistently been associated with an increased future risk of cardiovascular disease, irrespective of the antepartum screening protocol or diagnostic criteria by which gestational diabetes is diagnosed. We reasoned that the resultant heterogeneity in the severity of dysglycaemia in women with gestational diabetes suggests that the relationship between gestational glycaemia and subsequent cardiovascular disease probably extends int...
Source: The Lancet Diabetes and Endocrinology - Category: Endocrinology Source Type: research
tko J Abstract BACKGROUND: A myocardial bridge (MB) is defined as a congenital anomaly, in which a segment of an epicardial coronary artery takes an intramuscular course. AIM: To evaluate the prevalence of MB in coronary arteries among patients, who were diagnosed using coronarography. METHODS: The data were obtained from the National Polish Percutaneous Interventions Registry (ORPKI), among patients hospitalized between 01 January2014 and 31 December 2016 in invasive cardiology departments in Poland and divided into groups with and without MB. RESULTS: The study included 298 558 patients. The non-M...
Source: Kardiologia Polska - Category: Cardiology Authors: Tags: Kardiol Pol Source Type: research
A previously healthy, well-appearing 42-year-old female living in a modern, high-rise apartment in downtown Los Angeles calls 9-1-1 at 5:30 am complaining of worsening of a burning, epigastric pain she had been experiencing for the last three days. She reports associated nausea and non-bloody, non-bilious vomiting, and that she couldn’t manage to get comfortable in bed until she finally decided to call for help at daybreak. During her 9-1-1 call, she reports “pain, like heartburn, that just woke me up again and I had to throw up, … and then I was sweating so much.” Using the Los Angeles Tiered Disp...
Source: JEMS Special Topics - Category: Emergency Medicine Authors: Tags: Exclusive Articles Cardiac & Resuscitation Source Type: news
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