التفاصيل البيبلوغرافية
| العنوان: |
Predictors of cardiac events after major vascular surgery: Role of clinical characteristics, dobutamine echocardiography, and beta-blocker therapy |
| المؤلفون: |
Poldermans, D. (Don), Bax, J.J. (Jeroen), Steyerberg, E.W. (Ewout), Thomson, I.R. (Ian), Banga, J.D. (Jan), Urk, H. (Hero) van, Roelandt, J.R.T.C. (Jos), Ven, L.L.M. (Louis) van de, Boersma, H. (Eric) |
| المصدر: |
J A M A: The Journal of the American Medical Association |
| سنة النشر: |
2001 |
| المجموعة: |
RePub - Publications from Erasmus University, Rotterdam |
| مصطلحات موضوعية: |
Exercise Test, Postoperative Complications/mortality/prevention & control, Vascular Surgical Procedures, Adrenergic beta-Antagonists/*therapeutic use, Aged, Cardiotonic Agents/diagnostic use, Dobutamine/diagnostic use, Female, Humans, Logistic Models, Male, Multivariate Analysis, Myocardial Infarction/etiology/prevention & control, Myocardial Ischemia/*etiology/*prevention & control/ultrasonography, Predictive Value of Tests, Prognosis, Retrospective Studies, Risk |
| الوصف: |
CONTEXT: Patients who undergo major vascular surgery are at increased risk of perioperative cardiac complications. High-risk patients can be identified by clinical factors and noninvasive cardiac testing, such as dobutamine stress echocardiography (DSE); however, such noninvasive imaging techniques carry significant disadvantages. A recent study found that perioperative beta-blocker therapy reduces complication rates in high-risk individuals. OBJECTIVE: To examine the relationship of clinical characteristics, DSE results, beta-blocker therapy, and cardiac events in patients undergoing major vascular surgery. DESIGN AND SETTING: Cohort study conducted in 1996-1999 in the following 8 centers: Erasmus Medical Centre and Sint Clara Ziekenhuis, Rotterdam, Twee Steden Ziekenhuis, Tilburg, Academisch Ziekenhuis Utrecht, Utrecht, and Medisch Centrum Alkmaar, Alkmaar, the Netherlands; Ziekenhuis Middelheim, Antwerp, Belgium; and San Gerardo Hospital, Monza, Istituto di Ricovero e Cura a Carattere Scientifico, San Giovanni Rotondo, Italy. PATIENTS: A total of 1351 consecutive patients scheduled for major vascular surgery; DSE was performed in 1097 patients (81%), and 360 (27%) received beta-blocker therapy. MAIN OUTCOME MEASURE: Cardiac death or nonfatal myocardial infarction within 30 days after surgery, compared by clinical characteristics, DSE results, and beta-blocker use. RESULTS: Forty-five patients (3.3%) had perioperative cardiac death or nonfatal myocardial infarction. In multivariable analysis, important clinical determinants of adverse outcome were age 70 years or older; current or prior angina pectoris; and prior myocardial infarction, heart failure, or cerebrovascular accident. Eighty-three percent of patients had less than 3 clinical risk factors. Among this subgroup, patients receiving beta-blockers had a lower risk of cardiac complications (0.8% [2/263]) than those not receiving beta-blockers (2.3% [20/855]), and DSE had minimal additional prognostic value. In patients with 3 or more risk factors (17%), ... |
| نوع الوثيقة: |
article in journal/newspaper |
| وصف الملف: |
application/pdf |
| اللغة: |
English |
| العلاقة: |
http://repub.eur.nl/pub/9625Test; urn:hdl:1765/9625 |
| الإتاحة: |
http://repub.eur.nl/pub/9625Test |
| حقوق: |
info:eu-repo/semantics/openAccess |
| رقم الانضمام: |
edsbas.B770A18D |
| قاعدة البيانات: |
BASE |
