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ludc webb

Nuno Dias

Associate professor

ludc webb

Cardiovascular predictors for long-term mortality after EVAR for AAA

Author

  • Tomas Ohrlander
  • Magnus Dencker
  • Nuno Dias
  • Anders Gottsäter
  • Stefan Acosta

Summary, in English

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.

Department/s

  • Clinical Physiology, Malmö
  • Vascular Diseases - Clinical Research

Publishing year

2011

Language

English

Pages

422-427

Publication/Series

Vascular Medicine

Volume

16

Issue

6

Document type

Journal article

Publisher

SAGE Publications

Topic

  • Cardiac and Cardiovascular Systems

Keywords

  • anemia
  • cardiovascular
  • echocardiography
  • electrocardiogram
  • EVAR
  • mortality

Status

Published

Research group

  • Clinical Physiology, Malmö
  • Vascular Diseases - Clinical Research

ISBN/ISSN/Other

  • ISSN: 1477-0377