Incidental Pulmonary Embolism After Coronary Artery Bypass Surgery: Long-Term Clinical Follow-Up

Beck, Kyongmin Sarah; Cho, Eun Kyung; Moon, Mi Hyung; Kim, Do-Yeon; Song, Hyun; Jung, Jung Im

doi:10.2214/ajr.17.18186

Cited by 6 publications

(6 citation statements)

References 23 publications

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“…Previous studies showed similar 10–12 or lower mortality 13,14 in the iPE cancer patients. Also, in patients with iPE diagnosed after coronary bypass survival was very good despite the lack of anticoagulation in the majority of patients 16 . The reason for this discrepancy is not apparent but could be related to de relatively small number of patients 10–13,16 or by excluding patients with iPE if they had retrospectively established symptoms that may be related to PE 13,14 .…”

Section: Discussionmentioning

confidence: 99%

“…In the group of patients with trauma, 24% had iPE 15 . Among patients with coronary artery bypass grafting incidence of postoperative PE noted on routine follow‐up imaging was 6.2% 16 . Even in a nonhigh‐risk group of 7019 patients with coronary artery disease, the incidence of iPE was 1.1% 7 …”

Section: Introductionmentioning

confidence: 99%

“…15 Among patients with coronary artery bypass grafting incidence of postoperative PE noted on routine follow-up imaging was 6.2%. 16 Even in a nonhigh-risk group of 7019 patients with coronary artery disease, the incidence of iPE was 1.1%. 7 In the current study, we compare iPE and sPE, in all affected patients, and separately in patients with and without cancer, treated with anticoagulation in a clinical setting of maximal standardization of evidence-based practice, and anticoagulant selection based on patient clinic characteristics, with prospective systematic follow-up.…”

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confidence: 97%

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Incidental pulmonary embolism in cancer and noncancer patients: Prospective cohort study

Wysokinska

Houghton

Vlazny

et al. 2022

European J of Haematology

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Background: Clinical picture and outcome of incidental pulmonary embolism (iPE) compared to symptomatic pulmonary embolism (sPE) remain unclear.Methods: Demographics, recurrent venous thromboembolism (VTE), mortality, major bleeding, and clinically relevant nonmajor bleeding (CRNMB) were compared between iPE and sPE patients who were followed prospectively at Mayo Thrombophilia Clinic (March 1, 2013 to August 1, 2020).Results: Out of 3576 VTE patients, 1417 (39.6%) had PE: 562 (39.7%) iPE and 855 sPE. Patients with cancer were more likely to have iPE (400 iPE vs. 314 sPE) compared to those without cancer (162 iPE vs. 541 sPE). VTE recurrence rate (all per 100 person-years) was similar in all iPE and sPE patients (3.34 vs. 3.68, p = .50), with cancer (4.16 vs. 4.89, p = .370), and without cancer patients (0.89 vs. 2.80, p = .25).Higher mortality observed in all patients with iPE compared to sPE (46.45 vs. 23.47, p < .001) and with cancer (56.41 vs. 45.77, p = .03) became not significant after adjustment for age, antiplatelet therapy, metastases, and cancer location. Noncancer iPE patients had higher mortality (15.95 vs. 7.18, p = .006) even after adjustment (p = .05). The major bleeding rate was also higher in all patients iPE compared to sPE (7.10 vs. 3.68, p = .03), but not after adjustment (p = .974); higher major bleeding rate in noncancer patients (6.49 vs. 1.25, p = .007) remained significant after adjustment (.02). CRNMB rate was similar to iPE and sPE patients.Conclusion: iPE represents a more serious clinical condition compared to sPE as indicated by the higher mortality and major bleeding but these differences reflect underlying comorbidities rather than the seriousness of the embolic event.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

mentioning

confidence: 97%

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Incidental pulmonary embolism in cancer and noncancer patients: Prospective cohort study

Wysokinska

Houghton

Vlazny

et al. 2022

European J of Haematology

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“…Therefore, these patients should be instructed to quit smoking as early as possible to reduce postoperative APE. Previous studies [37][38][39] have shown that occurrence of APE is positively correlated with the operation time. Our study showed that the possibility of APE occurring increased as the operation time increased, which is consistent with related study results.…”

Section: Discussionmentioning

confidence: 99%

“…Our study showed that the possibility of APE occurring increased as the operation time increased, which is consistent with related study results. [37][38][39] A prolonged operation time increases stimulation to the body, and activates and aggregates neutrophils on the surface of the lungs through a series of inflammatory reactions. This then causes damage to endothelial factors of the lungs, leading to formation of thrombi.…”

Section: Discussionmentioning

confidence: 99%

Risk factors for acute pulmonary embolism in patients with off-pump coronary artery bypass grafting: implications for nursing

Zhou

Cao

et al. 2020

J Int Med Res

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Objective Acute pulmonary embolism (APE) is a serious complication after off-pump coronary artery bypass grafting (OPCABG). We aimed to analyze the risk factors for APE in patients with OPCABG. Methods In this retrospective, observational study, patients with OPCABG who were treated in our hospital from 1 January 2018 to 31 March 2020 were included. The basic characteristics of patients and results of preoperative laboratory examinations were collected and analyzed. Results A total of 707 patients with OPCABG were included and the incidence of APE was 3.21%. Left ventricular ejection fraction (LVEF), a history of smoking, number of bypass grafting, duration of surgery, and age were significant risk factors for APE in patients with OPCABG. The areas under the curves of LVEF, number of bypass grafting, duration of surgery, and age were 0.773, 0.759, 0.738, and 0.723, respectively. The cutoff values of LVEF, number of bypass grafting, duration of surgery, and age were 59.84, 3.18, 237.42, and 73.28, respectively. Conclusions LVEF, a history of smoking, number of bypass grafting, duration of surgery, and age may be risk factors for APE in patients with OPCABG. Early measures should be taken to target these risks to prevent APE.

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Post‐ICU Care and Other Complications

2020

Manual of Perioperative Care in Adult Cardiac Surgery

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Incidental Pulmonary Embolism After Coronary Artery Bypass Surgery: Long-Term Clinical Follow-Up

Cited by 6 publications

References 23 publications

Incidental pulmonary embolism in cancer and noncancer patients: Prospective cohort study

Incidental pulmonary embolism in cancer and noncancer patients: Prospective cohort study

Risk factors for acute pulmonary embolism in patients with off-pump coronary artery bypass grafting: implications for nursing

Post‐ICU Care and Other Complications

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