The Society of Thoracic Surgeons 2008 Cardiac Surgery Risk Models: Part 1—Coronary Artery Bypass Grafting Surgery

Shahian, David M.; O’Brien, Sean M.; Filardo, Giovanni; Ferraris, Victor A.; Haan, Constance K.; Rich, Jeffrey B.; Normand, Sharon‐Lise T.; DeLong, Elizabeth R.; Shewan, Cynthia M.; Dokholyan, Rachel S.; Peterson, Eric D.; Edwards, Fred H.; Anderson, Richard P.

doi:10.1016/j.athoracsur.2009.05.053

Cited by 1,016 publications

(662 citation statements)

References 31 publications

Supporting

Mentioning

630

Contrasting

Unclassified

Order By: Relevance

“…The EuroScore II35 incorporates preoperative EF but does not account for HF in the calculation of early operative mortality. The Society of Thoracic Surgeons risk model36 includes preoperative EF and New York Heart Association functional status (a classification of physical activity limitations) but not a history of HF. Our study highlights the need to revise the current risk scoring systems and improve the recognition and management of HFpEF, especially in women.…”

Section: Discussionmentioning

confidence: 99%

Prevalence and Long‐Term Survival After Coronary Artery Bypass Grafting in Women and Men With Heart Failure and Preserved Versus Reduced Ejection Fraction

Sun

Eddeen

2018

JAHA

View full text Add to dashboard Cite

BackgroundHeart failure (HF) with reduced ejection fraction (rEF) is a widely regarded prognosticator after coronary artery bypass grafting. HF with preserved ejection fraction (pEF) accounts for up to half of all HF cases and is associated with considerable morbidity and mortality in hospitalized cohorts. However, HFpEF outcomes have not been elucidated in cardiac surgical patients. We investigated the prevalence and outcomes of HFpEF and HFrEF in women and men following coronary artery bypass grafting.Methods and ResultsWe conducted a retrospective cohort study in Ontario, Canada, between October 1, 2008, and March 31, 2015, using Cardiac Care Network and Canadian Institute of Health Information data. HF is captured through a validated population‐based database of all Ontarians with physician‐diagnosed HF. We defined pEF as ejection fraction ≥50% and rEF as ejection fraction <50%. The primary outcome was all‐cause mortality. Analyses were stratified by sex. Mortality rates were calculated using Kaplan–Meier method. The relative hazard of death was assessed using multivariable Cox proportional hazard models. Of 40 083 patients (20.6% women), 55.5% had pEF without HF, 25.7% had rEF without HF, 6.9% had HFpEF, and 12.0% had HFrEF. Age‐standardized HFpEF mortality rates at 4±2 years of follow‐up were similar in women and men. HFrEF standardized HFpEF mortality rates were higher in women than men.ConclusionsWe found a higher prevalence and poorer prognosis of HFpEF in women. A history of HF was a more important prognosticator than ejection fraction. Preoperative screening and extended postoperative follow‐up should be focused on women and men with HF rather than on rEF alone.

show abstract

Section: Discussionmentioning

confidence: 99%

Prevalence and Long‐Term Survival After Coronary Artery Bypass Grafting in Women and Men With Heart Failure and Preserved Versus Reduced Ejection Fraction

Sun

Eddeen

2018

JAHA

View full text Add to dashboard Cite

show abstract

“…As a secondary analyses we applied the well documented 2008 Society of Thoracic Surgeons (STS) CABG risk model to our cohort 33. We sought to compare risk stratification methods across the models to assess outcomes in the higher risk sub‐cohort.…”

Section: Methodsmentioning

confidence: 99%

Predictive Ability of Novel Cardiac Biomarkers ST2, Galectin‐3, and NT‐ProBNP Before Cardiac Surgery

Polineni

Parker

Alam

et al. 2018

JAHA

View full text Add to dashboard Cite

BackgroundCurrent preoperative models use clinical risk factors alone in estimating risk of in‐hospital mortality following cardiac surgery. However, novel biomarkers now exist to potentially improve preoperative prediction models. An assessment of Galectin‐3, N‐terminal pro b‐type natriuretic peptide (NT‐ProBNP), and soluble ST2 to improve the predictive ability of an existing prediction model of in‐hospital mortality may improve our capacity to risk‐stratify patients before surgery.Methods and ResultsWe measured preoperative biomarkers in the NNECDSG (Northern New England Cardiovascular Disease Study Group), a prospective cohort of 1554 patients undergoing coronary artery bypass graft surgery. Exposures of interest were preoperative levels of galectin‐3, NT‐ProBNP, and ST2. In‐hospital mortality and adverse events occurring after coronary artery bypass graft were the outcomes. After adjustment, NT‐ProBNP and ST2 showed a statistically significant association with both their median and third tercile categories with NT‐ProBNP odds ratios of 2.89 (95% confidence interval [CI]: 1.04–8.05) and 5.43 (95% CI: 1.21–24.44) and ST2 odds ratios of 3.96 (95% CI: 1.60–9.82) and 3.21 (95% CI: 1.17–8.80), respectively. The model receiver operating characteristic score of the base prediction model (0.80 [95% CI: 0.72–0.89]) varied significantly from the new multi‐marker model (0.85 [95% CI: 0.79–0.91]). Compared with the Northern New England (NNE) model alone, the full prediction model with biomarkers NT‐proBNP and ST2 shows significant improvement in model classification of in‐hospital mortality.ConclusionsThis study demonstrates a significant improvement of preoperative prediction of in‐hospital mortality in patients undergoing coronary artery bypass graft and suggests that biomarkers can be used to identify patients at higher risk.

show abstract

“…Advanced age is a known risk factor in CABG 57. In a systematic review of 16 observational studies of CABG in octogenarians (18 685 ONCAB and 8938 OPCAB), in‐hospital mortality (pooled OR: 0.64; 95% CI, 0.44–0.93; P =0.02), and stroke (pooled OR: 0.61; 95% CI, 0.48–0.76; P <0.001) were significantly lower in OPCAB 58.…”

Section: Opcab In Specific Subsets Of Patientsmentioning

confidence: 99%

“…In fact, according to the STS CABG risk model, female sex is associated with increased risk of operative mortality (OR: 1.31), major complications (OR: 1.18), and increased hospital length of stay (OR: 1.24) 57. OPCAB, however, may narrow or eliminate this disparity in outcomes between women and men.…”

Section: Opcab In Specific Subsets Of Patientsmentioning

confidence: 99%

Off‐Pump Coronary Artery Bypass Grafting: 30 Years of Debate

Gaudino

Angelini

Antoniades

et al. 2018

JAHA

View full text Add to dashboard Cite

The Society of Thoracic Surgeons 2008 Cardiac Surgery Risk Models: Part 1—Coronary Artery Bypass Grafting Surgery

Cited by 1,016 publications

References 31 publications

Prevalence and Long‐Term Survival After Coronary Artery Bypass Grafting in Women and Men With Heart Failure and Preserved Versus Reduced Ejection Fraction

Prevalence and Long‐Term Survival After Coronary Artery Bypass Grafting in Women and Men With Heart Failure and Preserved Versus Reduced Ejection Fraction

Predictive Ability of Novel Cardiac Biomarkers ST2, Galectin‐3, and NT‐ProBNP Before Cardiac Surgery

Off‐Pump Coronary Artery Bypass Grafting: 30 Years of Debate

Contact Info

Product

Resources

About