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https://hdl.handle.net/2440/9942
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dc.contributor.author | Shah, P. | - |
dc.contributor.author | Hare, D. | - |
dc.contributor.author | Raman, J. | - |
dc.contributor.author | Gordon, I. | - |
dc.contributor.author | Chan, R. | - |
dc.contributor.author | Horowitz, J. | - |
dc.contributor.author | Rosalion, A. | - |
dc.contributor.author | Buxton, B. | - |
dc.date.issued | 2003 | - |
dc.identifier.citation | Journal of Thoracic and Cardiovascular Surgery, 2003; 126(5):1320-1327 | - |
dc.identifier.issn | 0022-5223 | - |
dc.identifier.issn | 1097-685X | - |
dc.identifier.uri | http://hdl.handle.net/2440/9942 | - |
dc.description | Copyright © 2003 The American Association for Thoracic Surgery | - |
dc.description.abstract | OBJECTIVE: The aim was to prospectively analyze all-cause mortality, predictors of survival, and late functional results after myocardial revascularization for ischemic cardiomyopathy over a 10-year follow-up. METHODS: We prospectively studied 57 patients with stable coronary artery disease and poor left ventricular ejection function (<35%), enrolled between 1989 and 1994. Stress thallium was analyzed in 37 patients to identify reversible ischemia. To avoid patients with a stunned myocardium, we excluded those with unstable angina or myocardial infarction within the previous 4 weeks. Mean age of the patients was 67 ± 8 years, and 93% of patients were men. Mean left ventricular ejection fraction was 0.28 ± 0.04, 50% were in Canadian Cardiovascular Society angina class III-IV, and 65% were in New York Heart Association functional class III-IV. RESULTS: Operative mortality was 1.7% (1/57). The mean left ventricular ejection fraction (0.30) at 15 months postoperatively did not change from before operation (0.28, P = .09). There were 8 deaths at 1 year and 42 deaths over the course of the study, producing a survival of 82.5% at 1 year, 55.7% at 5 years, and 23.9% at 10 years (95% confidence interval: 14.6%-39.1%). Symptom-free survival was 77.2% at 1 year and 20.3% at 10 years. The leading cause of death was heart failure in 29% (12/42). Multivariate analysis showed that large reversible defects on stress thallium were associated with improved left ventricular ejection fraction at 1 year (P = .01) but only male sex was associated with improved long-term survival (P = .036). CONCLUSIONS: Myocardial revascularization for ischemic cardiomyopathy is associated with good functional relief from the symptoms of angina initially and, to a lesser extent, heart failure. Revascularization may have the advantage of preserving the remaining left ventricular function. However, the long-term mortality remains high. | - |
dc.description.statementofresponsibility | Pallav J. Shah, David L. Hare, Jai S. Raman, Ian Gordon, Robert K. Chan, John D. Horowitz, Alex Rosalion, Brian F. Buxton | - |
dc.language.iso | en | - |
dc.publisher | Mosby Inc | - |
dc.source.uri | http://jtcs.ctsnetjournals.org/cgi/content/abstract/126/5/1320 | - |
dc.subject | Humans | - |
dc.subject | Cardiomyopathy, Dilated | - |
dc.subject | Myocardial Ischemia | - |
dc.subject | Ventricular Dysfunction, Left | - |
dc.subject | Treatment Outcome | - |
dc.subject | Myocardial Revascularization | - |
dc.subject | Coronary Artery Bypass | - |
dc.subject | Severity of Illness Index | - |
dc.subject | Analysis of Variance | - |
dc.subject | Proportional Hazards Models | - |
dc.subject | Probability | - |
dc.subject | Risk Assessment | - |
dc.subject | Survival Analysis | - |
dc.subject | Follow-Up Studies | - |
dc.subject | Prospective Studies | - |
dc.subject | Sampling Studies | - |
dc.subject | Predictive Value of Tests | - |
dc.subject | Time Factors | - |
dc.subject | Aged | - |
dc.subject | Middle Aged | - |
dc.subject | Female | - |
dc.subject | Male | - |
dc.title | Survival after myocardial revascularization for ischemic cardiomyopathy: A prospective ten-year follow-up study | - |
dc.type | Journal article | - |
dc.identifier.doi | 10.1016/S0022-5223(03)00809-2 | - |
pubs.publication-status | Published | - |
dc.identifier.orcid | Horowitz, J. [0000-0001-6883-0703] | - |
Appears in Collections: | Aurora harvest 4 Medicine publications |
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