Evidence map›Paper›PMID 31642980›Full record

ArticleHeart and vessels2020

Does additional coronary artery bypass grafting to aortic valve replacement in elderly patients affect the early and long-term outcome?

Francesco Formica, Serena Mariani, Stefano D'Alessandro, Gurmeet Singh, Michele Di Mauro, Maria Grazia Cerrito, Luigi Amerigo Messina, Salvatore Scianna, Francesca Papesso, Fabio Sangalli

Abstract read
In one paragraph

Article in Heart and vessels, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
9citing papers in PubMed, 2 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

9 citing papers in PubMed, 2 syntheses or guidelines pooled it.

  1. Pooled it
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Francesco FormicaDepartment of Medicine and Surgery, Cardiac Surgery Clinic, San Gerardo Hospital, University of Milano-Bicocca, Via G.B. Pergolesi 33, 20052, Monza, Italy. francesco_formica@fastwebnet.it.
Serena MarianiDepartment of Medicine and Surgery, Cardiac Surgery Clinic, San Gerardo Hospital, University of Milano-Bicocca, Via G.B. Pergolesi 33, 20052, Monza, Italy.
Stefano D'AlessandroDepartment of Medicine and Surgery, Cardiac Surgery Clinic, San Gerardo Hospital, University of Milano-Bicocca, Via G.B. Pergolesi 33, 20052, Monza, Italy.
Gurmeet SinghDepartment of Critical Care Medicine and Division of Cardiac Surgery, Department of Surgery, Mazankowski Alberta Heart Institute, University of Alberta, Edmonton, Canada.
Michele Di MauroHeart Department, SS Annunziata Hospital, Chieti, Italy.
Maria Grazia CerritoDepartment of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy.
Luigi Amerigo MessinaDepartment of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy.
Salvatore SciannaDepartment of Medicine and Surgery, Cardiac Surgery Clinic, San Gerardo Hospital, University of Milano-Bicocca, Via G.B. Pergolesi 33, 20052, Monza, Italy.
Francesca PapessoDepartment of Medicine and Surgery, Cardiac Surgery Clinic, San Gerardo Hospital, University of Milano-Bicocca, Via G.B. Pergolesi 33, 20052, Monza, Italy.
Fabio SangalliDepartment of Anaesthesia and Intensive Care Medicine, San Gerardo Hospital, Monza, Italy.

Funding

Fondi Ateneo Ricerca (F.A.R.) University of Milano-Bicocca, Italy 2011-ATE-0432
6 · The paper itself

Abstract

Early and long-term outcomes in elderly patients who underwent isolated aortic valve replacement (iAVR) are well defined. Conflicting data exist in elderly patients who underwent AVR plus coronary artery bypass grafting (CABG). We sought to evaluate the early and long-term outcomes of combined AVR + CABG in patients older than 75 years of age. From June 1999 to June 2018, 402 patients ≥ 75 years who underwent iAVR (n = 200; 49.7%) or combined AVR plus CABG (n = 202; 50.3%) were retrospectively analysed. AVR + CABG patients were older than iAVR patients (78.5 ± 2.5 vs 77.6 ± 2.8 years; p < 0.0001), with greater co-morbidities and more urgent/emergency surgery. 30-day mortality was 6.5% in the AVR + CABG and 4.5% in the iAVR group (p = 0.38). Multivariate analysis identified EuroSCORE II [odd ratio (OR) 1.13] postoperative stroke (OR 12.53), postoperative low cardiac output syndrome (OR 8.72) and postoperative mechanical ventilation > 48 h (OR 8.92) as independent predictors of 30-day mortality; preoperative cerebrovascular events (OR 3.43), creatinine (OR 7.27) and extracorporeal circulation time (OR 1.01) were independent predictors of in-hospital major adverse cardiovascular and cerebral events (MACCE). Treatment was not an independent predictor of 30-day mortality and in-hospital MACCE. Survival at 1, 5 and 10 years was 94.7 ± 1.6%, 72.6 ± 3.6% and 31.7 ± 4.8% for iAVR patients and 89.1 ± 2.3%, 73.9 ± 3.5% and 37.2 ± 4.8% for AVR + CABG subjects (p = 0.99). Using adjusted Cox regression model, creatinine [hazard ration (HR) 1.50; p = 0.018], COPD (HR 1.97; p = 0.003) and NYHA class (HR 1.39; p < 0.0001) were independent predictors of late mortality; the combined AVR + CABG was not associated with increased risk of late mortality (HR 0.83; p = 0.30). In patients aged ≥ 75 years, combined AVR + CABG was not associated with increased 30-day mortality, in-hospital MACCE and long-term mortality. Surgical revascularization can be safely undertaken at the time of AVR in elderly patients.

Indexed as

AgedAged, 80 and overAge FactorsAortic ValveCoronary Artery BypassFemaleHeart Valve DiseasesHeart Valve ProsthesisHeart Valve Prosthesis ImplantationHumansLogistic ModelsMaleMultivariate AnalysisPostoperative ComplicationsQuality of LifeRetrospective StudiesAVRCABGElderlyOutcomes

Identifiers

PMID31642980
PMCPMC7222122

What OpenQuestion holds

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Read underepoch 390

Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.