Frequency of concomitant ischemic heart disease and risk factor analysis for an early postoperative myocardial infarction after elective abdominal aortic aneurysm repair.
10.4174/astr.2016.90.3.171
- Author:
Seung Rim HAN
1
;
Young Wook KIM
;
Seon Hee HEO
;
Shin Young WOO
;
Yang Jin PARK
;
Dong Ik KIM
;
Jeonghoon YANG
;
Seung Hyuk CHOI
;
Duk Kyung KIM
Author Information
1. Division of Vascular Surgery, Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea. ywkim@skku.edu
- Publication Type:Original Article
- Keywords:
Abdominal aortic aneurysm;
Coronary artery disease;
Myocardial infarction;
Mortality
- MeSH:
Aneurysm;
Aortic Aneurysm, Abdominal*;
Coronary Artery Disease;
Exercise Test;
Humans;
Mortality;
Myocardial Infarction*;
Myocardial Ischemia*;
Prevalence;
Retrospective Studies;
Risk Factors*
- From:Annals of Surgical Treatment and Research
2016;90(3):171-178
- CountryRepublic of Korea
- Language:English
-
Abstract:
PURPOSE: We aimed to see the frequency of concomitant ischemic heart disease (IHD) in Korean patients with abdominal aortic aneurysm (AAA) and to determine risk factors for an early postoperative acute myocardial infarction (PAMI) after elective open or endovascular AAA repair. METHODS: We retrospectively reviewed a database of patients who underwent elective AAA repair over the past 11 years. Patients were classified into 3 groups: control group; group I, medical IHD treatment; group II, invasive IHD treatment. Rates of PAMI and mortality at 30 days were compiled and compared between groups according to the type of AAA repair. RESULTS: Six hundred two elective repairs of infrarenal or juxtarenal AAAs were enrolled in this study. The patients were classified into control group (n = 398, 66.1%), group I (n = 73, 12.1%) and group II (n = 131, 21.8%). PAMI developed more frequently after open surgical repair (OSR) than after endovascular aneurysm repair (EVAR) (5.4% vs. 1.3%, P = 0.012). In OSR patients (n = 373), PAMI developed 2.1% in control group, 18.0% in group I and 7.1% in group II (P < 0.001). In EVAR group (n = 229), PAMI developed 0.6% in control group, 4.3% in group I and 2.2% in group II (P = 0.211). On the multivariable analysis of risk factors of PAMI, PAMI developed more frequently in patients with positive functional stress test. CONCLUSION: The prevalence of concomitant IHD was 34% in Korean AAA patients. The risk of PAMI was significantly higher after OSR compared to EVAR and in patients with IHD compared to control group. Though we found some risk factors for PAMI, these were not applied to postoperative mortality rate.
