Does additional coronary artery bypass grafting to aortic valve replacement in elderly patients affect the early and long-term outcome?

AbstractEarly and long-term outcomes in elderly patients who underwent isolated aortic valve replacement (iAVR) are well defined. Conflicting data exist in elderly patients who underwent AVR plus coronary artery bypass grafting (CABG). We sought to evaluate the early and long-term outcomes of combined AVR  + CABG in patients older than 75 years of age. From June 1999 to June 2018, 402 patients ≥ 75 years who underwent iAVR (n = 200; 49.7%) or combined AVR plus CABG (n = 202; 50.3%) were retrospectively analysed. AVR + CABG patients were older than iAVR patients (78.5 ± 2.5 vs 77.6 ± 2.8 years;p   48 h (OR 8.92) as independent predictors of 30-day mortality; preoperative cerebrovascular events (OR 3.43), creatinine (OR 7.27) and extracorporeal circulation time (OR 1.01) were independent predictors of in-hospital major adverse cardiovascular and cerebral events (MACCE). Treatment was not a n independent predictor of 30-day mortality and in-hospital MACCE. Survival at 1, 5 and 10 years was 94.7 ± 1.6%, 72.6 ± 3.6% and 31.7 ± 4.8% for iAVR patients and 89.1 ± 2.3%, 73.9 ± 3.5% and 37.2 ± 4.8% for AVR + CABG subjects (p = 0.99). Using adjusted Cox regression model, creatinine [h...
Source: Heart and Vessels - Category: Cardiology Source Type: research

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CONCLUSION: A Clinical Endpoint Committee is useful for adjudication of major adverse cardiovascular events in chronic obstructive pulmonary disease trials but requires considerable resources and effort by investigators. This process can be streamlined by reviewing only serious adverse events and filtering by selected Medical Dictionary for Regulatory Activities terms. PMID: 32441114 [PubMed - as supplied by publisher]
Source: Clinical Trials - Category: Research Authors: Tags: Clin Trials Source Type: research
AbstractQuantitative analysis of modified barium swallow (MBS) imaging is useful to determine the impact of various disease states on pharyngeal swallowing mechanics. In this retrospective proof of concept study, kinematic analysis and computational analysis of swallowing mechanics (CASM) were used to demonstrate how these methods differentiate swallowing dysfunction by dysphagia etiology. Ten subjects were randomly selected from four cohorts of dysphagic patients including COPD, head and neck cancer (HNC), motor neuron disease, and stroke. Each subject was age- and gender-matched with healthy, non-dysphagic controls. MBS ...
Source: Dysphagia - Category: Speech-Language Pathology Source Type: research
CONCLUSIONS: Qigong research publications have been increasing gradually. Reports on study types, participants, Qigong Intervention, and outcomes are diverse and inconsistent. There is an urgent need to develop a set of reporting standards for various interventions of Qigong. Further trials of high methodological quality with sufficient sample size and real world studies are needed to verify the effects of Qigong in health and disease management. PMID: 32444061 [PubMed - as supplied by publisher]
Source: Complementary Therapies in Medicine - Category: Complementary Medicine Authors: Tags: Complement Ther Med Source Type: research
ConclusionsFracture-related burden is expected to increase over the coming decades. Given the substantial treatment gap and proven cost-effectiveness of fracture prevention schemes such as fracture liaison services, urgent action is needed to ensure that all individuals at high risk of fragility fracture are appropriately assessed and treated.
Source: Archives of Orthopaedic and Trauma Surgery - Category: Orthopaedics Source Type: research
HATCH score for prediction of progression from paroxysmal to persistent atrial fibrillation (AF) checks the following: heart failure, age, previous transient ischemic attack or stroke, chronic obstructive pulmonary disease, and hypertension [1]. For the analysis, the authors used over 1200 patients with paroxysmal AF who participated in Euro Heart Survey on AF. Those who had progression of AF after one year of follow up were noted. The components and weightage given in HATCH score were as follows: Hypertension: 1 Age 75 years or more: 1 Transient ischemic attack or stroke: 2 Chronic obstructive pulmonary disease: 1 Heart ...
Source: Cardiophile MD - Category: Cardiology Authors: Tags: Cardiology Source Type: blogs
CONCLUSIONS: This review found patterns of physical therapist practice for cardiorespiratory conditions, neurological conditions, and conditions requiring acute hospital care that were both evidence based and not evidence based. A concern is that a substantial percentage of physical therapists provided interventions that were of low value or unknown value, despite the availability of high-value interventions. IMPACT: This systematic review is the first to summarize the percentage of physical therapist treatment choices that were high value versus low value for cardiorespiratory conditions, neurological conditions, and...
Source: Physical Therapy - Category: Physiotherapy Authors: Tags: Phys Ther Source Type: research
Conclusion: Risk factors, aetiology, and precipitating factors of HF in de novo and ADCHF differ. De novo HF also had lower 1-year mortality and 3-month mortality compared to ADCHF. PMID: 32252602 [PubMed - as supplied by publisher]
Source: Acta Cardiologica - Category: Cardiology Tags: Acta Cardiol Source Type: research
This study aimed to ascertain whether tiotropium/olodaterol (T/O) 5/5 μg fixed-dose combination (FDC) may modulate the risk of main cardiovascular outcomes in COPD patients enrolled in randomized controlled trials (RCTs). A meta-analysis (CRD42017070100) was performed by selecting RCTs reporting raw data from the ClinicalTrials.gov database concerning the impact of T/O 5/5 µg FDC vs. monocomponents on the occurrence of specific cardiovascular serious adverse events: arrhythmia, heart failure, myocardial infarction, and stroke. Data were reported as relative risk and 95% Confidence Interval, and the r...
Source: COPD: Journal of Chronic Obstructive Pulmonary Disease - Category: Respiratory Medicine Tags: COPD Source Type: research
Conclusion: The mortality risk of patients with COPD is considerably increased by stroke independent of the other effects of COPD. Moreover, the average number of hospitalization days and frequency of medical visits dramatically increased in patients with COPD after stroke.
Source: International Journal of Environmental Research and Public Health - Category: Environmental Health Authors: Tags: Article Source Type: research
This study delves into the mechanisms by which a short period of fasting can accelerate wound healing. Fasting triggers many of the same cellular stress responses, such as upregulated autophagy, as occur during the practice of calorie restriction. It isn't exactly the same, however, so it is always worth asking whether any specific biochemistry observed in either case does in fact occur in both situations. In particular, the period of refeeding following fasting appears to have beneficial effects that are distinct from those that occur while food is restricted. Multiple forms of therapeutic fasting have been repor...
Source: Fight Aging! - Category: Research Authors: Tags: Newsletters Source Type: blogs
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