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Ketorolac improves graft patency after coronary artery bypass grafting: A propensity-matched analysis

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dc.contributor.author Engoren M.
dc.contributor.author Hadaway J.
dc.contributor.author Schwann T.A.
dc.contributor.author Habib R.H.
dc.contributor.editor
dc.date Aug-2011
dc.date.accessioned 2017-10-05T15:37:56Z
dc.date.available 2017-10-05T15:37:56Z
dc.date.issued 2011
dc.identifier 10.1016/j.athoracsur.2011.04.050
dc.identifier.isbn
dc.identifier.issn 00034975
dc.identifier.uri http://hdl.handle.net/10938/16044
dc.description.abstract Background: The use of ketorolac, a potent cyclooxygenase-1 inhibitor, for analgesia after cardiac operations has been limited by concerns of increased cardiovascular events. However, a recent study found that its use after coronary artery bypass grafting was associated with improved survival. Methods: This was a retrospective study of patients who received coronary arteriograms for symptoms suggestive of recurrent ischemic heart disease. Patients who received postoperative ketorolac were matched with nonusers by propensity scores. Graft occlusion rates were compared, and their association with ketorolac use was compared using Cox proportional hazard modeling. Results: Although the rate of graft occlusion was similar in the two groups, in 184 of the 303 propensity-matched patients (61percent) who received ketorolac vs 202 of the 303 patients (67percent) who did not (p = 0.13), there was a longer time to angiographically proven occlusion in the patients who received ketorolac (2.80 ± 2.19 vs 2.04 ± 1.63 years; p 0.001). Cox modeling to control for the other variables and the longer time to angiography in the ketorolac group showed that ketorolac use was associated with nearly a halving of the hazard ratio (0.561; 95percent confidence interval, 0.454 to 0.692; p 0.001) for any graft occlusion. Conclusions: The use of ketorolac after coronary artery bypass grafting was associated with a lower rate of angiographically proven graft closure and suggests a mechanistic (improved graft patency) explanation for the previously reported survival benefit of ketorolac. © 2011 The Society of Thoracic Surgeons.
dc.format.extent
dc.format.extent Pages: (603-609)
dc.language English
dc.publisher NEW YORK
dc.relation.ispartof Publication Name: Annals of Thoracic Surgery; Publication Year: 2011; Volume: 92; no. 2; Pages: (603-609);
dc.relation.ispartofseries
dc.relation.uri
dc.source Scopus
dc.subject.other
dc.title Ketorolac improves graft patency after coronary artery bypass grafting: A propensity-matched analysis
dc.type Article
dc.contributor.affiliation Engoren, M., Department of Anesthesiology, Mercy St. Vincent Medical Center, 2213 Cherry St, Toledo, OH 43608, United States, Department of Anesthesiology and Cardiothoracic Surgery, University of Toledo, College of Medicine, Toledo, OH, United States, Department of Anesthesiology, University of Florida, College of Medicine, Gainseville, FL, United States, Department of Internal Medicine, Outcomes Research Unit, American University of Beirut, Beirut, Lebanon
dc.contributor.affiliation Hadaway, J., Department of Anesthesiology, Mercy St. Vincent Medical Center, 2213 Cherry St, Toledo, OH 43608, United States, Department of Anesthesiology and Cardiothoracic Surgery, University of Toledo, College of Medicine, Toledo, OH, United States, Department of Anesthesiology, University of Florida, College of Medicine, Gainseville, FL, United States, Department of Internal Medicine, Outcomes Research Unit, American University of Beirut, Beirut, Lebanon
dc.contributor.affiliation Schwann, T.A., Department of Anesthesiology, Mercy St. Vincent Medical Center, 2213 Cherry St, Toledo, OH 43608, United States, Department of Anesthesiology and Cardiothoracic Surgery, University of Toledo, College of Medicine, Toledo, OH, United States, Department of Anesthesiology, University of Florida, College of Medicine, Gainseville, FL, United States, Department of Internal Medicine, Outcomes Research Unit, American University of Beirut, Beirut, Lebanon
dc.contributor.affiliation Habib, R.H., Department of Anesthesiology, Mercy St. Vincent Medical Center, 2213 Cherry St, Toledo, OH 43608, United States, Department of Anesthesiology and Cardiothoracic Surgery, University of Toledo, College of Medicine, Toledo, OH, United States, Department of Anesthesiology, University of Florida, College of Medicine, Gainseville, FL, United States, Department of Internal Medicine, Outcomes Research Unit, American University of Beirut, Beirut, Lebanon
dc.contributor.authorAddress Engoren, M.; Department of Anesthesiology, Mercy St. Vincent Medical Center, 2213 Cherry St, Toledo, OH 43608, United States; email: engoren@pol.net
dc.contributor.authorCorporate University: American University of Beirut Medical Center; Faculty: Faculty of Medicine; Department: Internal Medicine;
dc.contributor.authorDepartment Internal Medicine
dc.contributor.authorDivision
dc.contributor.authorEmail engoren@pol.net
dc.contributor.authorFaculty Faculty of Medicine
dc.contributor.authorInitials Engoren, M
dc.contributor.authorInitials Hadaway, J
dc.contributor.authorInitials Schwann, TA
dc.contributor.authorInitials Habib, RH
dc.contributor.authorOrcidID
dc.contributor.authorReprintAddress Engoren, M (reprint author), Mercy St Vincent Med Ctr, Dept Anesthesiol, 2213 Cherry St, Toledo, OH 43608 USA.
dc.contributor.authorResearcherID
dc.contributor.authorUniversity American University of Beirut Medical Center
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dc.description.citedCount 5
dc.description.citedTotWOSCount 4
dc.description.citedWOSCount 4
dc.format.extentCount 7
dc.identifier.articleNo
dc.identifier.coden ATHSA
dc.identifier.pubmedID 21801915
dc.identifier.scopusID 79960968357
dc.identifier.url
dc.publisher.address 360 PARK AVE SOUTH, NEW YORK, NY 10010-1710 USA
dc.relation.ispartofConference
dc.relation.ispartofConferenceCode
dc.relation.ispartofConferenceDate
dc.relation.ispartofConferenceHosting
dc.relation.ispartofConferenceLoc
dc.relation.ispartofConferenceSponsor
dc.relation.ispartofConferenceTitle
dc.relation.ispartofFundingAgency
dc.relation.ispartOfISOAbbr Ann. Thorac. Surg.
dc.relation.ispartOfIssue 2
dc.relation.ispartOfPart
dc.relation.ispartofPubTitle Annals of Thoracic Surgery
dc.relation.ispartofPubTitleAbbr Ann. Thorac. Surg.
dc.relation.ispartOfSpecialIssue
dc.relation.ispartOfSuppl
dc.relation.ispartOfVolume 92
dc.source.ID WOS:000293221000037
dc.type.publication Journal
dc.subject.otherAuthKeyword
dc.subject.otherChemCAS creatinine, 19230-81-0, 60-27-5
dc.subject.otherChemCAS ketorolac, 74103-06-3
dc.subject.otherChemCAS nitrogen, 7727-37-9
dc.subject.otherChemCAS urea, 57-13-6
dc.subject.otherChemCAS Anti-Inflammatory Agents, Non-Steroidal
dc.subject.otherChemCAS Cyclooxygenase Inhibitors
dc.subject.otherChemCAS Ketorolac, 66635-83-4
dc.subject.otherIndex creatinine
dc.subject.otherIndex ketorolac
dc.subject.otherIndex nitrogen
dc.subject.otherIndex urea
dc.subject.otherIndex adult
dc.subject.otherIndex aged
dc.subject.otherIndex angiocardiography
dc.subject.otherIndex artery graft
dc.subject.otherIndex article
dc.subject.otherIndex coronary artery bypass graft
dc.subject.otherIndex creatinine blood level
dc.subject.otherIndex drug dose comparison
dc.subject.otherIndex drug use
dc.subject.otherIndex female
dc.subject.otherIndex graft occlusion
dc.subject.otherIndex graft patency
dc.subject.otherIndex human
dc.subject.otherIndex internal mammary artery
dc.subject.otherIndex ischemic heart disease
dc.subject.otherIndex loading drug dose
dc.subject.otherIndex major clinical study
dc.subject.otherIndex male
dc.subject.otherIndex postoperative analgesia
dc.subject.otherIndex priority journal
dc.subject.otherIndex propensity score
dc.subject.otherIndex recurrent disease
dc.subject.otherIndex retrospective study
dc.subject.otherIndex saphenous vein graft
dc.subject.otherIndex survival
dc.subject.otherIndex urea nitrogen blood level
dc.subject.otherIndex Aged
dc.subject.otherIndex Anti-Inflammatory Agents, Non-Steroidal
dc.subject.otherIndex Coronary Angiography
dc.subject.otherIndex Coronary Artery Bypass
dc.subject.otherIndex Coronary Disease
dc.subject.otherIndex Coronary Restenosis
dc.subject.otherIndex Cyclooxygenase Inhibitors
dc.subject.otherIndex Dose-Response Relationship, Drug
dc.subject.otherIndex Drug Administration Schedule
dc.subject.otherIndex Drug Therapy, Combination
dc.subject.otherIndex Female
dc.subject.otherIndex Graft Occlusion, Vascular
dc.subject.otherIndex Humans
dc.subject.otherIndex Infusions, Intravenous
dc.subject.otherIndex Ketorolac
dc.subject.otherIndex Male
dc.subject.otherIndex Middle Aged
dc.subject.otherIndex Postoperative Complications
dc.subject.otherIndex Propensity Score
dc.subject.otherIndex Proportional Hazards Models
dc.subject.otherIndex Retrospective Studies
dc.subject.otherIndex Survival Rate
dc.subject.otherIndex Vascular Patency
dc.subject.otherKeywordPlus CYCLOOXYGENASE INHIBITORS
dc.subject.otherKeywordPlus ASPIRIN RESISTANCE
dc.subject.otherKeywordPlus NITRIC-OXIDE
dc.subject.otherKeywordPlus SURGERY
dc.subject.otherKeywordPlus VALDECOXIB
dc.subject.otherKeywordPlus THROMBOSIS
dc.subject.otherKeywordPlus MORTALITY
dc.subject.otherKeywordPlus PARECOXIB
dc.subject.otherKeywordPlus SURVIVAL
dc.subject.otherKeywordPlus SCORES
dc.subject.otherWOS Cardiac and Cardiovascular Systems
dc.subject.otherWOS Respiratory System
dc.subject.otherWOS Surgery


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