Evidence map›Paper›PMID 34082711›Full record

ArticleBMC cardiovascular disorders2021

Rapid decline in cardiac function in diabetic patients with calcified coronary artery disease undergoing hemodialysis: two case reports.

Hironobu Yamaoka, Taira Yamamoto, Daisuke Endo, Akie Shimada, Satoshi Matsushita, Tohru Asai, Atsushi Amano

Open access · goldAbstract readCase Reports
In one paragraph

Article in BMC cardiovascular disorders, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
0.2field-weighted citation impact, top 48% of its field
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

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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

0 citing papers in PubMed, 1 citations in OpenAlex.

No citing paper in PubMed yet.

4 · The record

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5 · Who and what money

Authors and funding

7 authors at 2 institutions in 1 country.

Hironobu YamaokaDepartment of Cardiovascular surgery, Edogawa Hospital, Higashi Koiwa 2-24-18, Edogawa-ku, Tokyo, 133-0052, Japan.
Taira YamamotoDepartment of Cardiovascular Surgery, Juntendo University, 2-1-1, Bunkyo-ku, Tokyo, 113-8421, Japan. tyamamo@juntendo.ac.jp.ORCID 0000-0003-2214-2539
Daisuke EndoDepartment of Cardiovascular Surgery, Juntendo University, 2-1-1, Bunkyo-ku, Tokyo, 113-8421, Japan.
Akie ShimadaDepartment of Cardiovascular Surgery, Juntendo University, 2-1-1, Bunkyo-ku, Tokyo, 113-8421, Japan.
Satoshi MatsushitaDepartment of Cardiovascular Surgery, Juntendo University, 2-1-1, Bunkyo-ku, Tokyo, 113-8421, Japan.
Tohru AsaiDepartment of Cardiovascular Surgery, Juntendo University, 2-1-1, Bunkyo-ku, Tokyo, 113-8421, Japan.
Atsushi AmanoDepartment of Cardiovascular Surgery, Juntendo University, 2-1-1, Bunkyo-ku, Tokyo, 113-8421, Japan.
Juntendo University · JPEdogawa Hospital · JP

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundClinical symptoms of patients on dialysis do not match the signs of coronary disease progression, making the prediction of the true progression of their medical condition in clinical settings difficult. Emergency and concomitant surgeries are significant risk factors of mortality following open-heart surgery in patients on hemodialysis. CASE PRESENTATION: We report two cases of successful coronary artery bypass grafting (CABG) in patients on dialysis with a history of cardiac surgery. The first case describes a 65-year-old woman who had undergone aortic valve replacement 2 years ago and was hospitalized urgently, because of a sudden decline in heart function and hypotension. She had moderate mitral regurgitation with right ventricular pressure of 66 mmHg and poor left ventricular function [left ventricular ejection fraction (LVEF), 40%]. Cineangiography revealed an increase in the rate of stenosis in the left main trunk, from 25 to 99% at admission, in addition to 100% occlusion in proximal left anterior descending artery (LAD) and 99% stenosis in the proximal left circumflex artery (LCX). We inserted an intra-aortic balloon pump preoperatively and performed emergency surgery (Euro II risk score, 61.7%; Society of Thoracic Surgeons (STS) risk score, 56.3%). The second case described a 78-year-old man who had undergone surgery for left atrial myxoma 4 years ago and was hospitalized urgently due to dyspnea, chest discomfort, and an LVEF of 44% (Euro II risk score, 40.7%; STS risk score, 33.2%). Cineangiography revealed an increase in the rate of stenosis in the proximal LAD, from 25% (4 years ago) to 90% at admission, in addition to 99% stenosis in proximal LCX and 95% stenosis in the posterolateral branch of LCX. Both patients underwent emergency CABG due to unstable hemodynamics and decreased left ventricular function despite regular dialysis. The surgeries were successful, and the patients were discharged without any complications.

conclusionsIn patients with multiple comorbidities and those who undergo dialysis treatment, calcified lesions in coronary arteries can progress severely and rapidly without any symptoms, including chest pain. Close outpatient management involving nephrologists and the cardiovascular team is necessary for patients on dialysis.

Indexed as

Coronary Artery BypassRenal DialysisAgedCoronary Artery DiseaseDiabetic NephropathiesDisease ProgressionEmergenciesFemaleHemodynamicsHumansKidney Failure, ChronicMaleRecovery of FunctionTreatment OutcomeVascular CalcificationVentricular Function, LeftCalcificationCoronary artery bypass graftingCoronary artery diseaseDiabetes mellitusHemodialysis

Identifiers

PMID34082711
PMCPMC8173516
OpenAlexW3165442792

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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.