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Fausto Biancari Tomas Gudbjartsson Jouni Heikkinen Vesa Anttila Timo Mäkikallio Anders Jeppsson Linda Thimour-Bergström Carmelo Mignosa Antonino S. Rubino Kari Kuttila Jarmo Gunn Jan-Ola Wistbacka Kari Teittinen Kari Korpilahti Francesco Onorati Giuseppe Faggian Giulia Vinco Corrado Vassanelli Flavio Ribichini Tatu Juvonen Tomas A. Axelsson Axel F. Sigurdsson Pasi P. Karjalainen Ari Mennander Olli Kajander Markku Eskola Erkki Ilveskoski Veronica D'Oria Marisa De Feo Tuomas Kiviniemi K.E. Juhani Airaksinen 《The American journal of cardiology》2014
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HRQoL after coronary artery bypass grafting and percutaneous coronary intervention for stable angina
Pertti Loponen Michael Luther Kari Korpilahti Jan-Ola Wistbacka Heini Huhtala Jari Laurikka 《Scandinavian cardiovascular journal : SCJ》2013,47(2):94-99
Objectives. To assess the health related quality of life (HRQoL) and the change in the NYHA class after coronary artery bypass grafting (CABG) or percutaneous coronary intervention (PCI) in the management of stable coronary artery disease (CAD). The study was non-randomized. CABG group consisted of 240 patients and 229 patients were treated with PCI. HRQoL was measured prospectively by the 15D instrument. Results. Three-year survival was 95.0 and 95.6% (NS). The HRQoL improved statistically in both groups until 6 months after treatment but deteriorated towards the end of the follow-up of 36 months. Clinically evident improvement of the HRQoL and decrease of the NYHA class took place more frequently among CABG patients. Conclusions. Despite initially more serious preoperative state and more demanding procedure CABG patients achieve equal level of HRQoL when compared with PCI patients. CABG patients may also obtain better relief from symptoms in mid-term follow-up. HRQoL cannot be the only factor to determine outcome after invasive treatment of CAD but it has to be placed in the context of the overall situation. 相似文献
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Reija Mikkola Jarmo Gunn Jouni Heikkinen Jan-Ola Wistbacka Kari Teittinen Kari Kuttila Jarmo Lahtinen Tatu Juvonen Juhani KE Airaksinen Fausto Biancari 《Trasfusione del sangue》2012,10(4):490-501
Background
The impact of blood transfusion on the development of post-operative stroke after coronary artery bypass grafting (CABG) is not well established. We, therefore, investigated this issue.Materials and methods.
Complete data on peri-operative blood transfusion were available for 2,226 patients who underwent CABG in three Finnish hospitals.Results
Stroke occurred post-operatively in 53 patients (2.4%). Logistic regression showed that pre-operative creatinine (OR 1.003, 95% CI 1.000–1.006), extracardiac arteriopathy (OR 2.344, 95% CI 1.133–4.847), pre-operative atrial fibrillation (OR 2.409, 95% CI 1.149–5.052), and the number of packed red blood cell units transfused (OR 1.121, 95% CI 1.065–1.180) were significantly associated with post-operative stroke. When the various blood product transfusions instead of transfused units were included in the multivariable analysis, solvent/detergent treated plasma (Octaplas®) transfusion (OR 2.149, 95% CI 1.141–4.047), but not red blood cell transfusion, was significantly associated with postoperative stroke. Use of blood products ranging from no transfusion (stroke rate 1.6%) to combined transfusion of red blood cells, platelets and Octaplas® was associated with a significant increase in post-operative stroke incidence (6.6%, adjusted analysis: OR 1.727, 95% 1.350–2.209). Patients who received >2 units of red blood cells, >4 units of Octaplas® units and >8 units of platelets had the highest stroke rate of 21%. CART analysis showed that increasing amount of transfused Octaplas®, platelets and history of extracardiac arteriopathy were significantly associated with post-operative stroke.Conclusions
Transfusion of blood products after CABG has a strong, dose-dependent association with the risk of stroke. The use of Octaplas® and platelet transfusions seem to have an even larger impact on the development of stroke than red blood cell transfusions. 相似文献4.
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Fausto Biancari Jari Laurikka Jan-Ola Wistbacka Juha Nissinen Matti Tarkka 《World journal of surgery》2010,34(12):2979-2984
Background
EuroSCORE is an adult cardiac surgery risk scoring method that is used worldwide, which has been shown to significantly overestimate the operative risk. We derived a new risk scoring method by modifying some of the risk factors included in the EuroSCORE algorithm and we validated it in an external database. 相似文献6.
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Loponen P Luther M Nissinen J Wistbacka JO Biancari F Laurikka J Sintonen H Tarkka MR 《Interactive Cardiovascular and Thoracic Surgery》2008,7(4):564-568
Three hundred and two patients were evaluated for the EuroSCORE risk and health-related quality of life (HRQoL) during three years after CABG as assessed by the 15D instrument. Both additive and logistic EuroSCORE correlated significantly with the 15D score at 6, 18 and 36 months. A clinically important increase > or =0.03 in the 15D score was achieved by 50.6% of patients at 6 months, 40.0% at 18 months and 35.9% at 36 months. The rates were similar among patients with increasing EuroSCORE at 6 and 18 months, but tended to decrease at 36 months in the highest EuroSCORE group (EuroSCORE 0-2: 46.8%; 3-5: 34.8%; and 6-14: 33.3%, respectively, P=0.13). Both additive (area under the receiver operating characteristic curve, AUC: 0.582, P=0.024) and logistic EuroSCORE (AUC: 0.575, P=0.039) were predictors of a significant increase of the 15D score. The best cut-off value of the additive EuroSCORE for prediction of a clinically important improvement of the 15D score during 3-year follow-up was 3, as 46.7% of patients with EuroSCORE 0-3 and 30.1% of patients with a score >3 (P=0.006) improved clinically. The present study showed that the EuroSCORE also predicts long-term HRQoL after CABG. 相似文献