Prognostic impact of preoperative atrial fibrillation in patients undergoing heart surgery in cardiogenic shock

被引：0
作者：
Mariusz Kowalewski
Giuseppe M. Raffa
Michał Pasierski
Michalina Kołodziejczak
Radosław Litwinowicz
Wojciech Wańha
Wojciech Wojakowski
Jan Rogowski
Marek Jasiński
Kazimierz Widenka
Tomasz Hirnle
Marek Deja
Krzysztof Bartus
Roberto Lorusso
Zdzisław Tobota
Bohdan Maruszewski
Piotr Suwalski
机构：
[1] National Medical Institute of the Ministry of Interior and Administration,Clinical Department of Cardiac Surgery and Transplantology, Centre of Postgraduate Medical Education
[2] Maastricht University Medical Centre,Cardio
[3] IRCCS-ISMETT,Thoracic Surgery Department, Heart and Vascular Centre
[4] Nicolaus Copernicus University,Department for the Treatment and Study of Cardiothoracic Diseases and Cardiothoracic Transplantation
[5] Regional Specialist Hospital,Department of Anaesthesiology and Intensive Care, Ludwik Rydygier Collegium Medicum
[6] Medical University of Silesia,Department of Cardiac Surgery
[7] Medical University of Gdansk,Department of Cardiology and Structural Heart Diseases
[8] Wroclaw Medical University,Department of Cardiac and Vascular Surgery
[9] University of Rzeszów,Department and Clinic of Cardiac Surgery
[10] Medical University of Bialystok,Clinical Department of Cardiac Surgery, District Hospital No. 2
[11] Upper-Silesian Heart Center,Department of Cardiosurgery
[12] The Children’s Memorial Health Institute,Department of Cardiac Surgery
[13] Collegium Medicum Nicolaus Copernicus University,Department of Pediatric Cardiothoracic Surgery
[14] Innovative Medical Forum,Thoracic Research Centre
[15] University Hospital,Department of Cardiac Surgery
[16] Medicover Hospital,Cardiac Surgery Department
[17] Masovian Specialistic Hospital of Radom,Department of Cardiac Surgery
[18] Pomeranian Medical University,Department of Cardiac Surgery
[19] J. Struś Hospital,Department of Cardiosurgery
[20] Medinet Heart Center Ltd,Department of Cardiac Surgery
[21] University Clinical Center of the Medical University of Warsaw,Department of Cardiovascular Surgery
[22] American Heart of Poland,Department of Cardiac Surgery
[23] Jagiellonian University Medical College,Department of Cardiovascular Surgery and Transplantology
[24] John Paul II Hospital,Department of Cardiac Surgery
[25] The Pope John Paul II Province Hospital,Department of Cardiac Surgery
[26] Military Institute of Medicine,Department of Pediatric Cardiac Surgery
[27] Pomeranian Traumatology Center,Cardiac Surgery Department
[28] Medical University of Warsaw,Department of Cardiac Surgery
[29] Medical University of Lublin,Department of Cardiac Surgery
[30] Ceynowa Specialist Hospital in Wejherowo,Department of Cardiac Surgery and Transplantology
[31] Lower Silesian Center for Heart Diseases,Department of Cardiac and General Pediatric Surgery
[32] Medical University of Lodz,Department of Cardiac Surgery, Institute of Medical Sciences
[33] Poznan University of Medical Sciences,Department of Anesthesiology and Intensive Therapy, Silesian Centre for Heart Diseases in Zabrze
[34] Medical University of Warsaw,Department of Cardiac Surgery
[35] University Hospital,Department of Cardiac Surgery and Transplantology
[36] University of Opole,Department of Medicine, Faculty of Medical Sciences and Health Sciences
[37] Medical University of Silesia,Cardiology and Cardiac Surgery Department
[38] Wroclaw Medical University,Department of Cardiac Surgery
[39] National Institute of Cardiology,Department of Cardiac Surgery
[40] Kazimierz Pulaski University of Technology and Humanities in Radom,Pediatric Cardiac Surgery
[41] 11th Military Research Hospital and Polyclinic IPHC in Bydgoszcz,Department of Cardiac Surgery
[42] Polish Mother’s Memorial Hospital Research Institute,Department of Paediatric Cardiac Surgery
[43] Department of Cardiac Surgery,2nd Department of Cardiac Surgery
[44] Swietokrzyskie Cardiology Center,Division of Cardiac Surgery, Heart and Lung Transplantation and Mechanical Circulatory Support
[45] Bieganski Hospital,Department of Cardiac Surgery
[46] Jagiellonian University,undefined
[47] 4Th Military Hospital,undefined
[48] Subcarpathian Center for Cardiovascular Intervention,undefined
[49] Poznan University of Medical Sciences,undefined
[50] Medical University of Silesia,undefined
来源：
Scientific Reports | / 13卷
关键词：
D O I：
暂无
中图分类号：
学科分类号：
摘要：
Surgical intervention in the setting of cardiogenic shock (CS) is burdened with high mortality. Due to acute condition, detailed diagnoses and risk assessment is often precluded. Atrial fibrillation (AF) is a risk factor for perioperative complications and worse survival but little is known about AF patients operated in CS. Current analysis aimed to determine prognostic impact of preoperative AF in patients undergoing heart surgery in CS. We analyzed data from the Polish National Registry of Cardiac Surgery (KROK) Procedures. Between 2012 and 2021, 332,109 patients underwent cardiac surgery in 37 centers; 4852 (1.5%) patients presented with CS. Of those 624 (13%) patients had AF history. Cox proportional hazards models were used for computations. Propensity score (nearest neighbor) matching for the comparison of patients with and without AF was performed. Median follow-up was 4.6 years (max.10.0), mean age was 62 (± 15) years and 68% patients were men. Thirty-day mortality was 36% (1728 patients). The origin of CS included acute myocardial infarction (1751 patients, 36%), acute aortic dissection (1075 patients, 22%) and valvular dysfunction (610 patients, 13%). In an unadjusted analysis, patients with underlying AF had almost 20% higher mortality risk (HR 1.19, 95% CIs 1.06–1.34; P = 0.004). Propensity score matching returned 597 pairs with similar baseline characteristics; AF remained a significant prognostic factor for worse survival (HR 1.19, 95% CI 1.00–1.40; P = 0.045). Among patients with CS referred for cardiac surgery, history of AF was a significant risk factor for mortality. Role of concomitant AF ablation and/or left atrial appendage occlusion or more aggressive perioperative circulatory support should be addressed in the future.
引用
收藏
相关论文
共 207 条
[1]  
Hollenberg SM(1999)Cardiogenic shock Ann. Intern. Med. 131 47-59
[2]  
Kavinsky CJ(2021)Mechanical complications of acute myocardial infarction: A review JAMA Cardiol. 6 341-349
[3]  
Parrillo JE(2017)Extra-corporeal membrane oxygenation for refractory cardiogenic shock after adult cardiac surgery: A systematic review and meta-analysis J. Cardiothorac. Surg. 12 55-383
[4]  
Gong FF(2019)Revascularization strategies in cardiogenic shock after acute myocardial infarction Curr. Opin. Crit. Care 25 379-2154
[5]  
Vaitenas I(2021)Coronary artery bypass grafting in cardiogenic shock: Decision-making, management options, and outcomes J. Cardiothorac. Vasc. Anesth. 35 2144-780
[6]  
Malaisrie SC(2019)Management of valvulopathies with acute severe heart failure and cardiogenic shock Arch. Cardiovasc. Dis. 112 773-1850
[7]  
Maganti K(2021)Cardiogenic shock after acute myocardial infarction: A review JAMA 326 1840-1920
[8]  
Khorsandi M(2017)Risk stratification for patients in cardiogenic shock after acute myocardial infarction J. Am. Coll. Cardiol. 69 1913-667
[9]  
Dougherty S(2022)Early risk stratification in patients with cardiogenic shock irrespective of the underlying cause—The cardiogenic shock score Eur. J. Heart Fail. 24 657-1810
[10]  
Bouamra O(2018)Venoarterial extracorporeal membrane oxygenation for cardiogenic shock and cardiac arrest Circ. Heart Fail. 11 e004905-914
12345678910