The Journal of thoracic and cardiovascular surgery
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J. Thorac. Cardiovasc. Surg. · Mar 2022
Observational StudyPreoperative clopidogrel and outcomes in patients with acute coronary syndrome undergoing coronary artery bypass surgery.
The optimal preoperative antiplatelet strategy for patients with acute coronary syndrome (ACS) requiring surgical revascularization remains unclear because of competing risks of bleeding and ischemic events. We evaluated the effect of clopidogrel within 5 days before coronary artery bypass grafting (CABG) on outcomes in patients with ACS. ⋯ Among patients with ACS undergoing CABG, clopidogrel therapy within 5 days before surgery was associated with increased odds of major cardiac and cerebrovascular events and bleeding complications than discontinuing clopidogrel for >5 days.
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J. Thorac. Cardiovasc. Surg. · Mar 2022
Respiratory strength and pectoralis muscle mass as measures of sarcopenia: Relation to outcomes in resected non-small cell lung cancer.
Physical biomarkers to stratify patients with lung cancer into subtypes predictive of outcome beyond tumor-related characteristics are underexplored. This study was designed to investigate the clinical utility of preoperative sarcopenia based on respiratory strength and pectoralis muscle mass to predict the risk of death. ⋯ Preoperative sarcopenia as identified by the criteria of low respiratory strength and reduced pectoralis muscle mass is significantly associated with poor overall survival. This may help to develop more individualized management strategies and optimize longitudinal care for patients.
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J. Thorac. Cardiovasc. Surg. · Mar 2022
Cerebral atherosclerosis and early ischemic stroke after left-sided valve replacement surgery.
Studies have rarely investigated whether cerebral atherosclerosis increases the risk of stroke after valve replacement surgery. This study evaluated the influence of cerebral atherosclerosis on the risk of stroke after left-sided valve replacement surgery. ⋯ Intracranial cerebral atherosclerosis was an important predictor of postoperative stroke, suggesting the necessity of further studies on the feasibility of preoperative screening for cerebral atherosclerosis in patients undergoing left-sided valve replacement surgery.