Validity of the Swedish Cardiac Surgery Registry

Vikholm, Per; Ivert, Torbjörn; Nilsson, Johan; Holmgren, Anders; Freter, Wolfgang; Ternström, Lisa; Ghaidan, Haider; Sartipy, Ulrik; Olsson, Christian; Granfeldt, Hans; Ragnarsson, Sigurður; Friberg, Örjan

doi:10.1093/icvts/ivy030

Cited by 78 publications

(54 citation statements)

References 15 publications

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“…The Swedish personal identity number allows nationwide registries with the possibility of long-term follow-up. The Swedish Web System for Enhancement and Development of Evidence-Based Care in Heart Disease Evaluated According to Recommended Therapies (SWEDEHEART) registry [ 19 , 20 ] provides data on all patients undergoing cardiac surgery in Sweden as well as records of angiographies and coronary interventions. Mortality yields limited information when used as sole outcome in studies of graft patency, as it is most probably only to a lesser degree influenced by the effects of failing grafts after CABG surgery [ 8 ].…”

Section: Introductionmentioning

confidence: 99%

Long-term clinical outcomes after coronary artery bypass grafting with pedicled saphenous vein grafts

Janiec

Friberg

Thelin

2018

J Cardiothorac Surg

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BackgroundCoronary artery bypass grafting (CABG) using saphenous vein grafts (SVG) is vitiated by poor long-term patency of the vein grafts. Pedicled SVG harvested with the “no-touch” (NT) technique have demonstrated improved patency and could confer better outcomes. We aim to compare long-term results after CABG where NT or conventional technique was used for vein graft harvesting in a hypothesis-generating registry-based study.MethodsTwo propensity score matched cohorts (1349 patients) undergoing CABG with veins harvested with NT (NTT) or conventional (CT) technique in Sweden over the period 2005–2015 were used to compare long-term outcomes. Mortality, postoperative incidence of coronary angiography and need for reintervention was recorded and multivariable hazard ratios adjusted for risk factors were calculated.ResultsThe mean follow-up time (SD) was 6.8 (3.3) years for NTT and 6.6 (3.2) years for CT. The adjusted hazard ratios for death, first angiography and need for reintervention for NTT patients were (95% CI) 0.97 (0.80–1.19), 0.76 (0.63–0.93), 0.91 (0.78–1.05), and 0.91 (0.71–1.17), respectively. Failed grafts were found in 43.2% of NTT patients and 53.6% of CT patients at angiography.ConclusionsIn this study NT grafting was associated with a lower risk for repeat angiography, however no difference could be observed for mortality and need for reintervention. The earlier reported improvements in patency of NT veins could possibly be reflected in an improved clinical outcome during the first 10 years after surgery.Electronic supplementary materialThe online version of this article (10.1186/s13019-018-0800-z) contains supplementary material, which is available to authorized users.

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Section: Introductionmentioning

confidence: 99%

Long-term clinical outcomes after coronary artery bypass grafting with pedicled saphenous vein grafts

Janiec

Friberg

Thelin

2018

J Cardiothorac Surg

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“…The SWEDEHEART registry and the NPR that were used to collect outcome data have high validity and are continuously monitored. [13][14][15][16] Limitations include the retrospective observational single-centre study design and that it was not possible to collect reliable information about perioperative myocardial infarctions. Furthermore, the indication for administering fibrinogen may vary between different treating physicians and the overall number of thromboembolic complications is most likely underreported since subclinical thromboembolic events are common.…”

Section: Discussionmentioning

confidence: 99%

“…Data regarding patient's characteristics, type of surgery, preand postoperative laboratory testing, bleeding volume, number of transfusions and fibrinogen administration were collected from patient's records and the Swedish Heart Surgery Registry, 13 which is a part of the SWEDEHEART registry. 14 Information about thromboembolic complications and mortality was collected from the National Patient Registry (NPR) and the Cause of Death Registry.…”

Section: Data Sourcesmentioning

confidence: 99%

“…A larger proportion of patients who received fibrinogen concentrate were transfused with RBCs (77.9 vs. 40.9%), plasma (61.5 vs. 13.8%), platelets (57.8 vs. 10.2%) and any transfusion of blood products (83.1 vs. 42.7%) (all p < 0.001). The median transfused volumes were higher in patients who received fibrinogen concentrate for any transfusion (8 [2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17] Patients who had a thrombotic event or died during follow-up were older, more often women, had higher Euroscore, significantly higher incidence of previous stroke and diabetes, higher fibrinogen concentration, lower haemoglobin concentration, inferior renal function, underwent more complex surgical procedures and received more blood transfusions (►Supplementary Tables S3 and S4 [available in the online version]).…”

Section: Statisticsmentioning

confidence: 99%

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Fibrinogen Concentrate to Cardiac Surgery Patients with Ongoing Bleeding does not Increase the Risk of Thromboembolic Complications or Death

et al. 2020

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Background We investigated whether fibrinogen concentrate administration to bleeding patients is associated with an increased risk of thromboembolic complications and death. Methods All consecutive patients who underwent first-time cardiac surgery at Sahlgrenska University Hospital from 2009 to 2014 were included. Patients, who had received fibrinogen concentrate, were compared with those who had not received fibrinogen concentrate. The primary endpoint was a composite of thromboembolic complications and death within 1 year after surgery. Secondary endpoints included the composite and mortality within 30 days and mortality within 1 year after surgery. Multivariable logistic regression and Cox regression models were used to compare the groups. Propensity score (PS)-matched models were used for sensitivity analyses. Results A total of 5,408 patients were included in the present study, of which 564 (10.4%) received fibrinogen concentrate. The composite endpoint occurred in 3.5% of patients at 30 days and 10.5% at 1 year. There was no significant difference between the groups in the composite endpoint at 1 year (adjusted hazard ratio [HR]: 1.11, 95% confidence interval [CI]: 0.84–1.46, p = 0.45) or in the secondary endpoints, that is, mortality at 1 year (adjusted HR: 1.38, 95% CI: 0.93–2.04, p = 0.11), composite at 30 days (adjusted odds ratio [OR]: 1.07, 95% CI: 0.64–1.81, p = 0.79) and mortality at 30 days (adjusted OR: 1.00, 95% CI: 0.51–1.96, p = 0.50). The results of the sensitivity analyses were consistent with those of main analyses. Conclusion Perioperative administration of fibrinogen concentrate to bleeding cardiac surgery patients is not associated with an increased risk of thromboembolic complications or death.

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“…The Swedish Web system for Enhancement and Development of Evidence-based care in Heart disease Evaluated According to Recommended Therapies (SWEDEHEART) register15 was used to identify patients who received porcine bioprosthetic aortic valves in Sweden between 1995 and 2012. The register collects pre, peri and postoperative parameters and outcomes of patients receiving cardiac surgery in Sweden 16…”

Section: Introductionmentioning

confidence: 99%

ABO blood type and risk of porcine bioprosthetic aortic valve degeneration: SWEDEHEART observational cohort study

Persson

Edgren

Dalén³

et al. 2019

BMJ Open

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ObjectiveBlood type A antigen on porcine aortic bioprostheses might initiate an immune reaction leading to an increased frequency of structural valve deterioration in patients with blood type B or O. The aim was to analyse the association between ABO blood type and porcine bioprosthetic aortic valve degeneration.DesignObservational nationwide cohort study.SettingSwedish population-based study.ParticipantsAdult patients (n=3417) who underwent surgical aortic valve replacement and received porcine bioprosthetic aortic valves between 1995 and 2012 from the Swedish Web system for Enhancement and Development of Evidence-based care in Heart disease Evaluated According to Recommended Therapies register. The study database was enriched with information from other national registers.ExposureThe patients were categorised into type A/AB and type B/O blood groups.Primary and secondary outcome measuresPrimary outcome measure was aortic valve reoperation, and secondary outcomes were heart failure and all-cause mortality. We report risk estimates that account for the competing risk of death.ResultsIn total, 3417 patients were identified: 1724 (50.5%) with blood type A/AB and 1693 (49.5%) with blood type B/O. Both groups had similar baseline characteristics. The cumulative incidence of aortic valve reoperation was 3.4% (95% CI 2.5% to 4.4%) and 3.6% (95% CI 2.6% to 4.6%) in the type B/O and the A/AB group, respectively, at 15 years of follow-up (absolute risk difference: −0.2% (95% CI −1.5% to 1.2%)). There was no significantly increased risk for aortic valve reoperation in patients with blood type B/O compared with type A/AB (HR 0.95, 95% CI 0.62 to 1.45). There was no significant difference in absolute or relative risk of heart failure or death between the groups.ConclusionsWe found no significant association between patient blood type and clinical manifestations of structural valve deterioration following porcine aortic valve replacement. Our findings suggest that it is safe to use porcine bioprosthetic valves without consideration of ABO blood type in the recipient.Trial registration numberNCT02276950

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Validity of the Swedish Cardiac Surgery Registry

Cited by 78 publications

References 15 publications

Long-term clinical outcomes after coronary artery bypass grafting with pedicled saphenous vein grafts

Long-term clinical outcomes after coronary artery bypass grafting with pedicled saphenous vein grafts

Fibrinogen Concentrate to Cardiac Surgery Patients with Ongoing Bleeding does not Increase the Risk of Thromboembolic Complications or Death

ABO blood type and risk of porcine bioprosthetic aortic valve degeneration: SWEDEHEART observational cohort study

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