Dataset Information

Incidence and predictors of intracranial bleeding after coronary artery bypass graft surgery.

ABSTRACT:

Background

There is a paucity of direct data on the incidence and predictors of intracranial bleeding (ICB) after coronary artery bypass graft surgery (CABG).

Methods

The Korean National Health Insurance database was used to identify patients without prior ICB who underwent CABG. The outcomes of interest were the time-dependent incidence rates of ICB and the associated mortality.

Results

Among 35,021 patients who underwent CABG between 2007 and 2018, 895 (2.6%) experienced an ICB during a median follow-up of 6.0 years. The 1-year cumulative incidence of ICB was 0.76%, with a relatively high incidence rate (9.93 cases per 1,000 person-years) within the first 1-30 days. Subsequent incidence rates showed a sharp decline until 3 years, followed by a steady decrease up to 10 years. The 1-year mortality rate after ICB was 38.1%, with most deaths occurring within 30 days (23.6%). The predictors of ICB after CABG were age ≥ 75 years, hypertension, pre-existing dementia, history of ischemic stroke or transient ischemic attack, and end-stage renal disease.

Conclusions

In an unselected nationwide population undergoing CABG, the incidence of ICB was non-negligible and showed a relatively high incidence rate during the early postoperative period. Post-CABG ICB was associated with a high risk of premature death. Further research is needed to stratify high-risk patients and personalize therapeutic decisions for preventing ICB after CABG.

SUBMITTER: Kim JH

PROVIDER: S-EPMC9411799 | biostudies-literature | 2022

REPOSITORIES: biostudies-literature

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Publications

Incidence and predictors of intracranial bleeding after coronary artery bypass graft surgery.

Kim Ju Hyeon JH Lee Pil Hyung PH Kim Ho Jin HJ Kim Joon Bum JB Park Sojeong S Kyoung Dae-Sung DS Kang Soo-Jin SJ Lee Seung-Whan SW Kim Young-Hak YH Lee Cheol Whan CW Chung Cheol Hyun CH Lee Jae Won JW Park Seong-Wook SW

Frontiers in cardiovascular medicine 20220812

<h4>Background</h4>There is a paucity of direct data on the incidence and predictors of intracranial bleeding (ICB) after coronary artery bypass graft surgery (CABG).<h4>Methods</h4>The Korean National Health Insurance database was used to identify patients without prior ICB who underwent CABG. The outcomes of interest were the time-dependent incidence rates of ICB and the associated mortality.<h4>Results</h4>Among 35,021 patients who underwent CABG between 2007 and 2018, 895 (2.6%) experienced ...[more]

PMID: 36035927

Similar Datasets

Project description:ObjectivesCoronary graft failure (CGF) may occur early after coronary bypass graft surgery (CABG). The study aimed to identify clinical and perioperative risk factors and to evaluate the long-term clinical impact of symptomatic early CGF.MethodsPatients who underwent clinically indicated coronary angiography (CAG) prior to post-CABG discharge between 2012 and 2022 were included. Symptomatic early CGF was defined as a dysfunctional coronary graft, evaluated on clinically indicated CAG, caused by stenosis of the proximal or distal anastomosis or bypass conduit, bypass occlusion, thrombosis, reduced flow (TIMI < 1) and kinking/tenting. Patients were divided into symptomatic early CGF and non-early CGF groups. Kaplan-Meier and multivariate analysis estimated cumulative survival free of major adverse cardiovascular events (MACE: death, myocardial infarction and revascularisation) up to 5 years' follow-up and identified predictors of symptomatic early CGF.ResultsA total of 92 patients (79% male, 66.1 ± 10 years old) were included, of whom 55 (59.8%) had symptomatic early CGF. Baseline characteristics, surgical parameters and post-surgical parameters potentially indicative of ischaemia were comparable between groups. Patients with symptomatic early CGF had a significantly lower MACE rate over a median follow-up period of 33 months (p = 0.023). Venous graft integration (p = 0.005), Y‑graft configuration (p = 0.002) and prolonged inotropic support (p = 0.032) were associated with symptomatic early CGF.ConclusionsSymptomatic early CGF was observed in the majority of post-CABG patients undergoing clinically indicated CAG prior to discharge. Patients with symptomatic early CGF exhibited higher MACE rates over a median follow-up period of 33 months. Venous graft integration, Y‑graft configuration and prolonged use of inotropic agents were associated with symptomatic early CGF. However, these clinical findings should be interpreted with caution.

Dataset Information

Incidence and predictors of intracranial bleeding after coronary artery bypass graft surgery.

Background

Methods

Results

Conclusions

Publications

Incidence and predictors of intracranial bleeding after coronary artery bypass graft surgery.

Similar Datasets

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