Advanced

Cardiovascular predictors for long-term mortality after EVAR for AAA

Ohrlander, Tomas; Dencker, Magnus LU ; Dias, Nuno LU ; Gottsäter, Anders LU and Acosta, Stefan LU (2011) In Vascular Medicine 16(6). p.422-427
Abstract
The aim of this study was to assess cardiovascular predictors for all-cause long-term mortality in patients undergoing standard endovascular aneurysm repair (EVAR) for infrarenal abdominal aortic aneurysm (AAA). Consecutive patients treated with EVAR (Zenith (R) stent grafts; Cook) between May 1998 and February 2006 were prospectively enrolled in a computerized database, together with retrospectively collected data on medication, and electrocardiographic and echocardiographic variables. Mortality was assessed on 1 December 2010. The median follow-up time was 68 months and the median age was 74 years (range 53-89) for the 304 patients. Mortality at the end of follow-up was 54.3% (165/304). The proportion of deaths caused by vascular... (More)
The aim of this study was to assess cardiovascular predictors for all-cause long-term mortality in patients undergoing standard endovascular aneurysm repair (EVAR) for infrarenal abdominal aortic aneurysm (AAA). Consecutive patients treated with EVAR (Zenith (R) stent grafts; Cook) between May 1998 and February 2006 were prospectively enrolled in a computerized database, together with retrospectively collected data on medication, and electrocardiographic and echocardiographic variables. Mortality was assessed on 1 December 2010. The median follow-up time was 68 months and the median age was 74 years (range 53-89) for the 304 patients. Mortality at the end of follow-up was 54.3% (165/304). The proportion of deaths caused by vascular diseases was 61% (101/165). In the univariate analysis, low preoperative ejection fraction (EF) (p = 0.004), absence of statin medication (p = 0.007), and medication with diuretics (p = 0.028) or digitalis (p = 0.016) were associated with an increased long-term mortality rate. Myocardial ischemia on electrocardiogram (ECG) (hazard ratio (HR) 1.6 [95% CI 1.1-2.4]) and anemia (HR 1.5 [95% CI 1.0-2.1]) were found to be independent predictors for long-term mortality after Cox regression analysis. There was a trend that chronic kidney disease, stage >= 3 (HR 1.5 [95% CI 1.0-2.2]), and age 80 years and above (HR 1.5 [95% CI 1.0-2.4]) were independently associated with long-term mortality. In conclusion, ischemia on ECG and anemia were independently related to an increased long-term mortality rate after EVAR, and these predictive factors seem to be most important for critical assessment in the preoperative medical work-up. (Less)
Please use this url to cite or link to this publication:
author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
anemia, cardiovascular, echocardiography, electrocardiogram, EVAR, mortality
in
Vascular Medicine
volume
16
issue
6
pages
422 - 427
publisher
SAGE Publications Inc.
external identifiers
  • wos:000297480100002
  • scopus:82955247125
ISSN
1477-0377
DOI
10.1177/1358863X11425713
language
English
LU publication?
yes
id
ce9482d6-cbc8-49a1-923b-3afba52d0f8c (old id 2279333)
date added to LUP
2012-01-11 15:01:56
date last changed
2017-01-29 03:04:45
@article{ce9482d6-cbc8-49a1-923b-3afba52d0f8c,
  abstract     = {The aim of this study was to assess cardiovascular predictors for all-cause long-term mortality in patients undergoing standard endovascular aneurysm repair (EVAR) for infrarenal abdominal aortic aneurysm (AAA). Consecutive patients treated with EVAR (Zenith (R) stent grafts; Cook) between May 1998 and February 2006 were prospectively enrolled in a computerized database, together with retrospectively collected data on medication, and electrocardiographic and echocardiographic variables. Mortality was assessed on 1 December 2010. The median follow-up time was 68 months and the median age was 74 years (range 53-89) for the 304 patients. Mortality at the end of follow-up was 54.3% (165/304). The proportion of deaths caused by vascular diseases was 61% (101/165). In the univariate analysis, low preoperative ejection fraction (EF) (p = 0.004), absence of statin medication (p = 0.007), and medication with diuretics (p = 0.028) or digitalis (p = 0.016) were associated with an increased long-term mortality rate. Myocardial ischemia on electrocardiogram (ECG) (hazard ratio (HR) 1.6 [95% CI 1.1-2.4]) and anemia (HR 1.5 [95% CI 1.0-2.1]) were found to be independent predictors for long-term mortality after Cox regression analysis. There was a trend that chronic kidney disease, stage >= 3 (HR 1.5 [95% CI 1.0-2.2]), and age 80 years and above (HR 1.5 [95% CI 1.0-2.4]) were independently associated with long-term mortality. In conclusion, ischemia on ECG and anemia were independently related to an increased long-term mortality rate after EVAR, and these predictive factors seem to be most important for critical assessment in the preoperative medical work-up.},
  author       = {Ohrlander, Tomas and Dencker, Magnus and Dias, Nuno and Gottsäter, Anders and Acosta, Stefan},
  issn         = {1477-0377},
  keyword      = {anemia,cardiovascular,echocardiography,electrocardiogram,EVAR,mortality},
  language     = {eng},
  number       = {6},
  pages        = {422--427},
  publisher    = {SAGE Publications Inc.},
  series       = {Vascular Medicine},
  title        = {Cardiovascular predictors for long-term mortality after EVAR for AAA},
  url          = {http://dx.doi.org/10.1177/1358863X11425713},
  volume       = {16},
  year         = {2011},
}