INCIDENCE OF MAJOR ADVERSE CARDIOVASCULAR EVENTS AFTER CARDIAC SURGERY PROCEDURES
Autori:
Nenad Lakušić, Franjo Baborski, Jasna Čerkez Habek, Zdenko Sonicki, Duško Cerovec, Marcel Majsec
Sažetak
Sažetak. Cilj rada bio je analizirati pojavnost velikih neželjenih srčanožilnih događaja nakon kardiokirurških zahvata. Analizirano je ukupno 307 bolesnika koji su prethodno bili podvrgnuti nekom kardiokirurškom zahvatu unutar 6 mjeseci do dolaska na drugu fazu stacionarne kardiološke rehabilitacije. U 101 bolesnika (33%) učinjena je ugradnja aortnog ili mitralnog arteficijelnog zaliska, dok je 206 bolesnika (67%) podvrgnuto kardiokirurškoj revaskularizaciji miokarda (CABG). Krajnje točke praćenja podijeljene su u primarne (smrt zbog akutnog infarkta miokarda (IM) ili nagla smrt) i sekundarne (nefatalni IM ili nestabilna angina pektoris, moždani udar, novi kardiokirurški zahvat ili perkutana koronarna intervencija, srčano popuštanje ili značajna aritmija, smrt nekardijalnog uzroka). Prosječno vrijeme praćenja bolesnika nakon završene rehabilitacije bilo je 35 ± 21 mjesec. Tijekom razdoblja praćenja ukupno je zabilježena 61 primarna ili sekundarna točka. U skupini bolesnika s CABG zabilježeno je 48, a u skupini bolesnika s ugrađenim arteficijelnim zali¬skom 13 velikih neželjenih srčanožilnih događaja (p=0,03). Zabilježeno je ukupno 19 smrti od fatalnog IM ili smrti koja je nastupila naglo (6%). Unutar skupine bolesnika s CABG bilo je 16, a unutar skupine bolesnika s ugrađenim arteficijelnim zaliskom bile su 3 smrti kardiovaskularnog uzroka (NS). Rezultati ovog istraživanja pokazuju da se komplikacije nakon kardiokirurških zahvata znatno češće javljaju u skupini bolesnika s CABG-om. Ukupno gledajući, stopa smrtnosti unutar analizirane skupine bolesnika podvrgnutih CABG-u ili ugradnji arteficijelnog zaliska u promatranom razdoblju nakon operacije relativno je niska.
Summary
Summary. The aim of the study was to analyze the incidence of major adverse cardiovascular events after different cardiac surgery procedures. This study included 307 patients who underwent some of cardiac surgery procedures within a period of 6 months of arriving at stationary cardiac rehabilitation. There were 101 patients (33%) who had valve surgery and 206 patients (67%) who underwent coronary artery bypass grafting (CABG). Primary end-point was death caused by fatal myocardial infarction (MI) or sudden death, and secondary end-points were non-fatal MI or unstable angina pectoris, stroke, new cardiac surgery or percutaneous coronary intervention, heart failure or significant arrhythmia and non-cardiac death. The mean duration of follow-up period after leaving stationary cardiac rehabilitation was 35 ± 21 months. During the ¬follow up period, there was total of 61 primary and secondary end-points. In CABG group, there were 48 major adverse cardiovascular events compared to 13 in the group of patients with prosthetic valve (p=0.03). There was total of 19 fatal MI or sudden death (6%). The fatal outcome rates of cardiovascular origin were significantly higher in the group of patients after CABG than in the patients with prosthetic valve (16 vs. 3 death, NS). The results of this study suggest that the complications after cardiac surgery procedures occurs more often in CABG patients. However, mortality rate after cardiac surgery in the analyzed groups of patients is relatively low.
