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Preoperative albumin corrected anion gap is associated with in-hospital and long-term mortality in patients undergoing coronary artery bypass grafting in a retrospective cohort study

BACKGROUND: Coronary artery disease remains a global health concern and the leading cause of death. Till today, coronary artery bypass grafting (CABG) is one of the main treatment strategies for coronary artery disease, especially for Multivessel coronary disease or complex coronary lesions. The pre...

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Autores principales: Wang, Ruiling, Li, Jiale, Chen, Huimin, Xiao, Zezhou, Xu, Rongning, Hu, Yu, Chen, Sikai, Wang, Xiaowu, Zheng, Shaoyi
Formato: Online Artículo Texto
Lenguaje:English
Publicado: AME Publishing Company 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9840039/
https://www.ncbi.nlm.nih.gov/pubmed/36647463
http://dx.doi.org/10.21037/jtd-22-1633
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author Wang, Ruiling
Li, Jiale
Chen, Huimin
Xiao, Zezhou
Xu, Rongning
Hu, Yu
Chen, Sikai
Wang, Xiaowu
Zheng, Shaoyi
author_facet Wang, Ruiling
Li, Jiale
Chen, Huimin
Xiao, Zezhou
Xu, Rongning
Hu, Yu
Chen, Sikai
Wang, Xiaowu
Zheng, Shaoyi
author_sort Wang, Ruiling
collection PubMed
description BACKGROUND: Coronary artery disease remains a global health concern and the leading cause of death. Till today, coronary artery bypass grafting (CABG) is one of the main treatment strategies for coronary artery disease, especially for Multivessel coronary disease or complex coronary lesions. The present study aimed to explore the relationship of preoperative albumin corrected anion gap (ACAG) with mortality in all those patients who undergoing CABG. METHODS: All the patients undergoing CABG were included in the study. All clinical data were collected from CareVue and MetaVision system. The predictive value of ACAG for mortality was determined by receiver operating characteristic (ROC) curves survival curves were estimated using the Kaplan-Meier method. Multivariate regression models were constructed to determine the association of ACAG with mortality. RESULTS: A total of 2,180 patients were identified and divided into a high ACAG group (ACAG ≥16.0 mmol/L) and low ACAG group (ACAG <16.0 mmol/L) according to the ROC analysis. Patients in the high ACAG group were older and presented with more comorbidities and concomitant valvular surgeries. Further more, in the high ACAG group, we observed a higher length of stay in the intensive care unit [3.88 (2.15, 7.09) vs. 2.29 (1.29, 3.94), P<0.001]. Both the in-hospital mortality [28 (4.5%) vs. 11 (0.7%), P<0.001], and the 4-year mortality [125 (27.1%) vs. 111 (12.7%), P<0.001] were also rised in those patients. And it was also showed in the survival curves, patients with ACAG ≥16.0 mmol/L had a significant lower 4-year survival (P<0.001). While in the multivariate regression model, we found ACAG was act as an independent risk factor for both the in-hospital mortality [odds ratio (OR): 1.248 (1.060, 1.470), P=0.008] and the 4-year mortality [hazard ratio (HR): 1.134 (1.063, 1.210), P<0.001]. An ACAG ≥16.0 mmol/L was significantly associated with a 2.7-fold risk of in-hospital mortality [OR: 2.732 (1.129, 6.610), P=0.026]. CONCLUSIONS: Preoperative ACAG is an independent risk factor for in-hospital and long-term mortality in CABG patients. A higher ACAG may relate to severe coronary artery stenosis and cardiac dysfunction, which is more likely to lead to a postoperative systemic inflammatory response, microcirculation disorder, and subsequent complications.
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spelling pubmed-98400392023-01-15 Preoperative albumin corrected anion gap is associated with in-hospital and long-term mortality in patients undergoing coronary artery bypass grafting in a retrospective cohort study Wang, Ruiling Li, Jiale Chen, Huimin Xiao, Zezhou Xu, Rongning Hu, Yu Chen, Sikai Wang, Xiaowu Zheng, Shaoyi J Thorac Dis Original Article BACKGROUND: Coronary artery disease remains a global health concern and the leading cause of death. Till today, coronary artery bypass grafting (CABG) is one of the main treatment strategies for coronary artery disease, especially for Multivessel coronary disease or complex coronary lesions. The present study aimed to explore the relationship of preoperative albumin corrected anion gap (ACAG) with mortality in all those patients who undergoing CABG. METHODS: All the patients undergoing CABG were included in the study. All clinical data were collected from CareVue and MetaVision system. The predictive value of ACAG for mortality was determined by receiver operating characteristic (ROC) curves survival curves were estimated using the Kaplan-Meier method. Multivariate regression models were constructed to determine the association of ACAG with mortality. RESULTS: A total of 2,180 patients were identified and divided into a high ACAG group (ACAG ≥16.0 mmol/L) and low ACAG group (ACAG <16.0 mmol/L) according to the ROC analysis. Patients in the high ACAG group were older and presented with more comorbidities and concomitant valvular surgeries. Further more, in the high ACAG group, we observed a higher length of stay in the intensive care unit [3.88 (2.15, 7.09) vs. 2.29 (1.29, 3.94), P<0.001]. Both the in-hospital mortality [28 (4.5%) vs. 11 (0.7%), P<0.001], and the 4-year mortality [125 (27.1%) vs. 111 (12.7%), P<0.001] were also rised in those patients. And it was also showed in the survival curves, patients with ACAG ≥16.0 mmol/L had a significant lower 4-year survival (P<0.001). While in the multivariate regression model, we found ACAG was act as an independent risk factor for both the in-hospital mortality [odds ratio (OR): 1.248 (1.060, 1.470), P=0.008] and the 4-year mortality [hazard ratio (HR): 1.134 (1.063, 1.210), P<0.001]. An ACAG ≥16.0 mmol/L was significantly associated with a 2.7-fold risk of in-hospital mortality [OR: 2.732 (1.129, 6.610), P=0.026]. CONCLUSIONS: Preoperative ACAG is an independent risk factor for in-hospital and long-term mortality in CABG patients. A higher ACAG may relate to severe coronary artery stenosis and cardiac dysfunction, which is more likely to lead to a postoperative systemic inflammatory response, microcirculation disorder, and subsequent complications. AME Publishing Company 2022-12 /pmc/articles/PMC9840039/ /pubmed/36647463 http://dx.doi.org/10.21037/jtd-22-1633 Text en 2022 Journal of Thoracic Disease. All rights reserved. https://creativecommons.org/licenses/by-nc-nd/4.0/Open Access Statement: This is an Open Access article distributed in accordance with the Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International License (CC BY-NC-ND 4.0), which permits the non-commercial replication and distribution of the article with the strict proviso that no changes or edits are made and the original work is properly cited (including links to both the formal publication through the relevant DOI and the license). See: https://creativecommons.org/licenses/by-nc-nd/4.0 (https://creativecommons.org/licenses/by-nc-nd/4.0/) .
spellingShingle Original Article
Wang, Ruiling
Li, Jiale
Chen, Huimin
Xiao, Zezhou
Xu, Rongning
Hu, Yu
Chen, Sikai
Wang, Xiaowu
Zheng, Shaoyi
Preoperative albumin corrected anion gap is associated with in-hospital and long-term mortality in patients undergoing coronary artery bypass grafting in a retrospective cohort study
title Preoperative albumin corrected anion gap is associated with in-hospital and long-term mortality in patients undergoing coronary artery bypass grafting in a retrospective cohort study
title_full Preoperative albumin corrected anion gap is associated with in-hospital and long-term mortality in patients undergoing coronary artery bypass grafting in a retrospective cohort study
title_fullStr Preoperative albumin corrected anion gap is associated with in-hospital and long-term mortality in patients undergoing coronary artery bypass grafting in a retrospective cohort study
title_full_unstemmed Preoperative albumin corrected anion gap is associated with in-hospital and long-term mortality in patients undergoing coronary artery bypass grafting in a retrospective cohort study
title_short Preoperative albumin corrected anion gap is associated with in-hospital and long-term mortality in patients undergoing coronary artery bypass grafting in a retrospective cohort study
title_sort preoperative albumin corrected anion gap is associated with in-hospital and long-term mortality in patients undergoing coronary artery bypass grafting in a retrospective cohort study
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9840039/
https://www.ncbi.nlm.nih.gov/pubmed/36647463
http://dx.doi.org/10.21037/jtd-22-1633
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