Predictors of diseased ascending aorta in patients undergoing off-pump coronary artery bypass surgery.
OBJECTIVE
To identify the preoperative risk factors associated with increased prevalence of atherosclerotic lesions of the ascending aorta among patients undergoing off-pump coronary artery bypass surgery (OPCAB).


METHODS
OPCAB was performed in 241 patients who were intraoperatively investigated by epiaortic ultrasound for the presence of atherosclerotic lesions of the ascending aorta. The Northern New England Cardiovascular Disease Study Group (NNECVDSG) and the Multicenter Study of Perioperative Ischemia (McSPI) stroke risk scores were retrospectively calculated.


RESULTS
A diseased ascending aorta was detected by intraoperative epiaortic ultrasound in 74 patients (30.7%). Patient's age (P = .002, odds ratio [OR] 1.067, 95% confidence interval [CI] 1.025-1.110), diabetes (P = .023; OR, 2.211; 95% CI, 1.117-4.378), extracardiac arteriopathy (P = .014; OR, 2.567; 95% CI, 1.214-5.428) and urgent/emergency operation (P < .0001; OR, 3.066; 95% CI, 1.685-5.580) were independent preoperative predictors of a diseased ascending aorta. The area under the ROC curve of the NNECVDSG score in predicting a diseased ascending aorta was 0.710 (95% CI, 0.642-0.778), and that of the McSPI score was 0.722 (95% CI, 0.655-0.788). The prevalence of a diseased ascending aorta was 11.2%, 34.7%, and 49.4% among the NNECVDSG score tertiles (P < .0001), and 11.3%, 31.7%, and 49.4% among the McSPI score tertiles (P < .0001).


CONCLUSIONS
These findings confirm the reported high incidence of a diseased ascending aorta in patients undergoing coronary artery bypass surgery. Current stroke risk scores, particularly the simple NNECVDSG score, are valuable predictors of increased prevalence of a diseased ascending aorta.
Biancari
Fausto
F
Division of Cardiothoracic and Vascular Surgery, Department of Surgery, Oulu University Hospital, Oulu, Finland. faustobiancari@yahoo.it
Heikkinen
Jouni
J
Mosorin
Martti
M
Rasinaho
Elsi
E
Lahtinen
Jarmo
J
Niemelä
Eija
E
Lepojärvi
Martti
M
Juvonen
Tatu
T
D000368:Aged; D001011:Aorta; D001018:Aortic Diseases / Q000175:diagnosis* / Q000453:epidemiology*; D050197:Atherosclerosis / Q000453:epidemiology* / Q000601:surgery*; D015897:Comorbidity; D047549:Coronary Artery Bypass, Off-Pump / Q000706:statistics & numerical data*; D005260:Female; D005387:Finland / Q000453:epidemiology; D006305:Health Status Indicators; D006801:Humans; D015994:Incidence; D008297:Male; D017063:Outcome Assessment, Health Care / Q000379:methods*; D011300:Preoperative Care / Q000379:methods; D011379:Prognosis; D015203:Reproducibility of Results; D018570:Risk Assessment / Q000379:methods*; D012307:Risk Factors; D012680:Sensitivity and Specificity