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A new anatomic score for prognosis after cardiac catheterization in patients with previous bypass surgery.

Publication ,  Journal Article
Liao, L; Kong, DF; Shaw, LK; Sketch, MH; Milano, CA; Lee, KL; Mark, DB
Published in: J Am Coll Cardiol
November 1, 2005

OBJECTIVES: The purpose of this study was to determine the value of a new anatomic score for prognosis after diagnostic catheterization in patients with previous coronary artery bypass grafting (CABG). BACKGROUND: Previous CABG patients comprise a growing proportion of patients with coronary artery disease (CAD). Whereas prognostic scores are available to adjust for native CAD, there are no comparable scores for patients with previous CABG. METHODS: We studied 3,178 previous CABG patients (2,729 in a training set) who underwent cardiac catheterization. With a Cox model to develop relative weights in the training set, we created a graft index that adjusted native anatomy for territories with grafts free of significant (> or =75%) stenoses. Scaling the regression coefficients by the maximum coefficient created an index ranging from 0 to 100, where 100 was three-vessel CAD with no patent grafts. RESULTS: The graft index was significantly associated with all-cause death (chi-square = 121.9, p < 0.001). In combined models, the index was more strongly associated with all-cause death than either number of diseased vessels (chi-square = 68.0 and 1.7, respectively) or the Duke CAD index (chi-square = 54.3 and 9.5, respectively). In models for death using an independent validation set, the index was also associated more strongly than either native disease descriptors. In a model including other clinical variables, the graft index remained significantly associated with all-cause death (chi-square = 40.1, p < 0.001). CONCLUSIONS: For previous CABG patients, the Duke graft index was significantly more associated with prognosis than native anatomy alone and quantifies the effect of patent grafts on survival. This tool has the potential to help determine prognosis and inform the referral of post-CABG patients to repeat revascularization procedures.

Duke Scholars

Published In

J Am Coll Cardiol

DOI

EISSN

1558-3597

Publication Date

November 1, 2005

Volume

46

Issue

9

Start / End Page

1684 / 1692

Location

United States

Related Subject Headings

  • Prognosis
  • Middle Aged
  • Male
  • Humans
  • Female
  • Coronary Artery Disease
  • Coronary Artery Bypass
  • Cardiovascular System & Hematology
  • Cardiac Catheterization
  • Aged
 

Citation

APA
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Liao, L., Kong, D. F., Shaw, L. K., Sketch, M. H., Milano, C. A., Lee, K. L., & Mark, D. B. (2005). A new anatomic score for prognosis after cardiac catheterization in patients with previous bypass surgery. J Am Coll Cardiol, 46(9), 1684–1692. https://doi.org/10.1016/j.jacc.2005.06.074
Liao, Lawrence, David F. Kong, Linda K. Shaw, Michael H. Sketch, Carmelo A. Milano, Kerry L. Lee, and Daniel B. Mark. “A new anatomic score for prognosis after cardiac catheterization in patients with previous bypass surgery.J Am Coll Cardiol 46, no. 9 (November 1, 2005): 1684–92. https://doi.org/10.1016/j.jacc.2005.06.074.
Liao L, Kong DF, Shaw LK, Sketch MH, Milano CA, Lee KL, et al. A new anatomic score for prognosis after cardiac catheterization in patients with previous bypass surgery. J Am Coll Cardiol. 2005 Nov 1;46(9):1684–92.
Liao, Lawrence, et al. “A new anatomic score for prognosis after cardiac catheterization in patients with previous bypass surgery.J Am Coll Cardiol, vol. 46, no. 9, Nov. 2005, pp. 1684–92. Pubmed, doi:10.1016/j.jacc.2005.06.074.
Liao L, Kong DF, Shaw LK, Sketch MH, Milano CA, Lee KL, Mark DB. A new anatomic score for prognosis after cardiac catheterization in patients with previous bypass surgery. J Am Coll Cardiol. 2005 Nov 1;46(9):1684–1692.
Journal cover image

Published In

J Am Coll Cardiol

DOI

EISSN

1558-3597

Publication Date

November 1, 2005

Volume

46

Issue

9

Start / End Page

1684 / 1692

Location

United States

Related Subject Headings

  • Prognosis
  • Middle Aged
  • Male
  • Humans
  • Female
  • Coronary Artery Disease
  • Coronary Artery Bypass
  • Cardiovascular System & Hematology
  • Cardiac Catheterization
  • Aged