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Efficacy and safety of anticoagulant therapy started pre-operatively in preventing coronary vein graft occlusion.

https://arctichealth.org/en/permalink/ahliterature55102
Source
Eur Heart J. 1992 Sep;13(9):1259-64
Publication Type
Article
Date
Sep-1992
Author
S. Yli-Mäyry
H V Huikuri
U R Korhonen
K E Airaksinen
M J Ikäheimo
M K Linnaluoto
J T Takkunen
Author Affiliation
Department of Medicine, Oulu University Central Hospital, Finland.
Source
Eur Heart J. 1992 Sep;13(9):1259-64
Date
Sep-1992
Language
English
Publication Type
Article
Keywords
Aspirin - administration & dosage - adverse effects
Coronary Artery Bypass
Coronary Disease - blood - surgery
Dipyridamole - administration & dosage - adverse effects
Drug Therapy, Combination
Female
Follow-Up Studies
Graft Occlusion, Vascular - blood - prevention & control
Heart Catheterization
Humans
Male
Middle Aged
Premedication
Reoperation
Research Support, Non-U.S. Gov't
Warfarin - administration & dosage - adverse effects
Abstract
Oral anticoagulant therapy with warfarin commenced pre-operatively (n = 102) to prevent coronary artery vein graft occlusions was compared in terms of efficacy and safety with dipyridamole and aspirin (n = 130) in a randomized consecutive series of patients. Anticoagulant therapy was started at least 2 weeks before coronary artery bypass surgery (CABG) and antiplatelet therapy was started at least 3 days before CABG with dipyridamole followed by a combination of 250 mg aspirin once a day via a nasogastric tube 6 h after CABG. Overall, vein graft patency at 3 months after surgery did not differ significantly between the anticoagulant group (203/275, 74%) and dipyridamole-aspirin group (238/311, 77%), but the occlusion rate for grafts with endarterectomy was higher in the anticoagulant (46%) than in the dipyridamole and aspirin group (16%), (P less than 0.05). The rate of peri-operative complications including deaths, re-operation and myocardial infarction was higher in the anticoagulant than antiplatelet group (26.5% vs 13.8%, P less than 0.05). The occurrence of postoperative bleeding complications did not differ significantly between the groups. Thus, oral anticoagulant therapy commenced pre-operatively has no advantages over conventional antiplatelet therapy in patients who undergo CABG. Neither antithrombotic regimens proved to be satisfactory for preventing acute bypass vein graft occlusions in this patient population with advanced coronary artery disease.
Notes
Comment In: Eur Heart J. 1993 May;14(5):7238508869
PubMed ID
1396838 View in PubMed
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Preoperative C-reactive protein and outcome after coronary artery bypass surgery.

https://arctichealth.org/en/permalink/ahliterature47318
Source
Ann Thorac Surg. 2003 Dec;76(6):2007-12
Publication Type
Article
Date
Dec-2003
Author
Fausto Biancari
Jarmo Lahtinen
Samuli Lepojärvi
Pekka Rainio
Esa Salmela
Risto Pokela
Martti Lepojärvi
Jari Satta
Tatu S Juvonen
Author Affiliation
Division of Cardiothoracic and Vascular Surgery, Department of Surgery, University of Oulu and Oulu University Hospital, Oulu, Finland. faustobiancari@yahoo.it
Source
Ann Thorac Surg. 2003 Dec;76(6):2007-12
Date
Dec-2003
Language
English
Publication Type
Article
Keywords
Aged
C-Reactive Protein - analysis
Cardiac Output, Low - etiology
Cardiopulmonary Bypass
Cerebrovascular Disorders - etiology
Coronary Artery Bypass - adverse effects - mortality
Coronary Disease - blood - surgery
Female
Humans
Male
Middle Aged
Multivariate Analysis
Predictive value of tests
Prognosis
Research Support, Non-U.S. Gov't
Sensitivity and specificity
Stroke Volume
Treatment Outcome
Abstract
BACKGROUND: C-reactive protein (CRP) is a predictor of early and late outcome after coronary angioplasty, but there is scant data on its impact on the outcome after coronary artery bypass grafting (CABG). METHODS: The predictive value of preoperative CRP was evaluated in a series of 764 patients who underwent on-pump CABG. RESULTS: During the in-hospital stay, 13 patients (1.7%) died, 45 (4.5%) developed low cardiac output syndrome, and 28 (3.7%) suffered minor or major cerebrovascular complications. Patients with a preoperative serum concentration of CRP>/=1.0 mg/dL had a higher risk of overall postoperative death (5.3% vs 1.1%, p = 0.001), cardiac death (4.4% vs 0.8%, p = 0.002), low cardiac output syndrome (8.8% vs 3.7%, p = 0.01), and any cerebrovascular complication (4.4% vs 3.5%, p = 0.66). Preoperative serum concentration of CRP>/=1.0 mg/dL was significantly more frequent among patients with history of myocardial infarction, diabetes, lower limb ischemia, low left ventricular ejection fraction, NYHA class IV, and in those undergoing urgent or emergency operation. At multivariate analysis, preoperative serum concentration of CRP >/= 1.0 mg/dL (p = 0.01, O.R.: 6.97) and left ventricular ejection fraction (p = 0.01, O.R.: 0.95) were independent predictors of postoperative death. Postoperative mortality rate was 0.3% among patients with preoperative CRP /=50%, whereas it was 21.4% among those with a preoperative CRP >/= 1.0 mg/dL and an ejection fraction less than 50% (p
PubMed ID
14667631 View in PubMed
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[The manifestations of the immediate bioincompatibility reaction in patients undergoing restorative heart operations]

https://arctichealth.org/en/permalink/ahliterature54307
Source
Fiziol Zh. 1998;44(4):10-4
Publication Type
Article
Date
1998
Author
V S Shevchenko
Author Affiliation
Institute of Cardiovascular Surgery, Academy of Medical Sciense, Ukraine.
Source
Fiziol Zh. 1998;44(4):10-4
Date
1998
Language
Ukrainian
Publication Type
Article
Keywords
Autoantibodies - blood
Biocompatible Materials - adverse effects
Blood Proteins - analysis
Coronary Artery Bypass
Coronary Disease - blood - surgery
Endocarditis - blood - surgery
English Abstract
Heart Valve Prosthesis Implantation
Humans
Hypersensitivity, Immediate - blood - etiology
Immunodiffusion
Immunoelectrophoresis
Precipitins - blood
Time Factors
Abstract
The generation in plasma the anodic autoprecipitating protein, or autoprecipitin (AAP), as the bioincompatibility reaction under influence of a number of alien components during cardiac operations with using cardiopulmonary bypass, heterotopic vascular autotransplants and artificial valve implants was studied in 257 patients. Selective formation of the AAPs in result of their inductors effect was discovered by the methods of immunodiffusion and immunoelectrophoresis in blood of patients within operation periods and early postoperation hours. Repeated and reiterated generation of the AAPs due to bioincompatibility in patients with coronarosclerosis and endocarditis, undergoing prosthetic cardiac operations may favour developing reaction of immediate hypersensitivity with complications and has prognostic value.
PubMed ID
9669169 View in PubMed
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