Tehran Heart Center, Cardiovascular Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran.
Cardiac Primary Prevention Research Center, Cardiovascular Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran.
BMC Cardiovasc Disord. 2024 Apr 5;24(1):195. doi: 10.1186/s12872-024-03860-9.
Using the cardiac surgery database is of high importance in referral centers and can lead to a better quality of care for patients. Tehran Heart Center (THC) is a cardiovascular referral center that was inaugurated in 2001. In this report, we aimed to present the third report of trends in patients' cardiovascular risk factors and surgical procedures from 2002 to 2021 that have been gathered for all THC patients.
This serial cross-sectional study was conducted at Tehran Heart Center from 2002 to 2021. All patients undergoing cardiac surgeries were eligible to enter the study (N = 63,974). Those with miscellaneous types of surgeries were excluded (N = 9556). The distribution of cardiac surgeries (including isolated coronary artery bypass graft (CABG), isolated valve, and CABG + valve surgeries) and their respective in-hospital mortality were recorded. Furthermore, 20-year trends in the prevalence of various cardiovascular risk factors (CVRFs) among the following groups were evaluated: a) isolated CABG, b) aortic valve replacement/repair for aortic stenosis (AS/AVR/r), and c) isolated other valve surgeries (IVS).
A total of 54,418 patients (male: 70.7%, age: 62.7 ± 10.8 years) comprised the final study population, with 84.5% prevalence of isolated CABG. Overall, the AS/AVR/r group was in between the CABG and IVS groups concerning CVRFs distribution. Excluding some exceptions for the AS/AVR/r group (in which the small sample size (N = 909) precluded observing a clear trend), all studied CVRFs demonstrated an overall rising trend from 2002 to 2021 in all three groups. Regarding in-hospital mortality, the highest rate was recorded as 4.0% in 2020, while the lowest rate was 2.0% in 2001.
Isolated CABG remained the most frequent procedure in THC. Notable, increasing trends in CVRFs were observed during this 20-year period and across various types of cardiac surgeries, which highlights the clinical and policy-making implications of our findings.
在转诊中心，使用心脏手术数据库具有重要意义，可以提高患者的护理质量。德黑兰心脏中心（THC）是一家心血管转诊中心，成立于 2001 年。在本报告中，我们旨在介绍 2002 年至 2021 年期间收集的所有 THC 患者心血管危险因素和手术程序的趋势的第三次报告。
本系列横断面研究于 2002 年至 2021 年在德黑兰心脏中心进行。所有接受心脏手术的患者均有资格入组（N=63974）。排除接受其他类型手术的患者（N=9556）。记录心脏手术（包括单纯冠状动脉旁路移植术（CABG）、单纯瓣膜手术和 CABG+瓣膜手术）的分布及其各自的住院死亡率。此外，评估了以下各组中各种心血管危险因素（CVRFs）的 20 年趋势：a）单纯 CABG，b）主动脉瓣狭窄的主动脉瓣置换/修复（AS/AVR/r）和 c）单纯其他瓣膜手术（IVS）。
共有 54418 例患者（男性：70.7%，年龄：62.7±10.8 岁）构成最终研究人群，其中单纯 CABG 的患病率为 84.5%。总体而言，AS/AVR/r 组在 CVRFs 分布方面介于 CABG 和 IVS 组之间。除了 AS/AVR/r 组的一些例外情况（由于样本量小（N=909），无法观察到明显的趋势）外，所有研究的 CVRFs 在三组中均表现出从 2002 年到 2021 年的总体上升趋势。关于住院死亡率，最高发生率为 2020 年的 4.0%，而最低发生率为 2001 年的 2.0%。
单纯 CABG 仍然是 THC 最常见的手术。值得注意的是，在这 20 年期间，各种类型的心脏手术中 CVRFs 的上升趋势明显，这突显了我们研究结果的临床和决策意义。
