Seasonal Incidence of Emergent Coronary Artery Bypass Grafting Surgery

Authors

  • Jimmy T. Efird 1. East Carolina Heart Institute, Department of Cardiovascular Sciences, East Carolina University, Greenville, NC 2.Center for Health Disparities, Brody School of Medicine, East Carolina University, Greenville, NC 3. The College of Nursing, East Carolina University, Greenville, NC
  • William Fenner Griffin Department of Internal Medicine, Medical University of South Carolina, Charleston, SC
  • Stephen W. Davies Department of Surgery, University of Virginia School of Medicine, Charlottesville, VA
  • Wesley T. O’Neal Department of Internal Medicine, Wake Forest School of Medicine, Winston-Salem, NC
  • Patricia B. Crane The College of Nursing, East Carolina University, Greenville, NC
  • Linda C. Kindell East Carolina Heart Institute, Department of Cardiovascular Sciences, East Carolina University, Greenville, NC
  • Jason B. O’Neal Department of Anesthesiology, Vanderbilt University Medical Center, Nashville, TN
  • W. Randolph Chitwood, Jr. East Carolina Heart Institute, Department of Cardiovascular Sciences, East Carolina University, Greenville, NC
  • Alan P. Kypson East Carolina Heart Institute, Department of Cardiovascular Sciences, East Carolina University, Greenville, NC

DOI:

https://doi.org/10.1532/hsf.1277

Abstract

Background: Emergent coronary artery bypass grafting (CABG) surgery is often required in the case of severe coronary artery disease, which is refractory to traditional management. The objective of our study was to test the hypothesis that there is seasonal variation in the incidence of emergent CABG.
Methods: A sinusoidal logistic regression model was used to analyze operative data at our cardiovascular institute of 270 cases spanning 5939 calendar days.
Results: A cyclic peak risk for emergent CABG was observed for late winter (calendar day 66; P = .036). The odds ratios for the 1-, 2- and 3-month window surrounding this peak were 1.8 (95% CI = 0.94-3.5, P = .072), 1.6 (95% CI = 1.06-2.5, P = .024) and 1.4 (95% CI = 0.9-1.8, P = .066), respectively.
Conclusion: Our results suggest that a seasonal variation may exist in the incidence of patients presenting with severe coronary artery disease requiring emergent CABG. This information is useful in the scheduling of hospital resources and staff. It also provides important etiology clues underlying coronary artery disease that may lead to future interventions or targeted therapies.

References

Arku RE, Adamkiewicz G, Vallarino J, Spengler JD, Levy DE. 2015. Seasonal variability in environmental tobacco smoke exposure in public housing developments. Indoor Air 25:13-20.

Arntz HR, Willich SN, Schreiber C, Bruggemann T, Stern R, Schultheiss HP. 2000. Diurnal, weekly and seasonal variation of sudden death. Population-based analysis of 24,061 consecutive cases. Eur Heart J 21:315-20.

Crump C, Sundquist J, Sieh W, Winkleby MA, Sundquist K. 2014. Season of birth and risk of Hodgkin and non-Hodgkin lymphoma. Int J Cancer 135:2735-9.

Dempster AP, Laird NM, Rubin DB. 1977. Maximum likelihood from incomplete data via the EM algorithm. J Royal Statistic Soc Series B, Statistical Method 39:38.

Efird JT, O’Neal WT, Davies SW, O’Neal JB, Kypson AP. 2014. Seasonal incidence of hospital admissions for Stanford type A aortic dissection. Chronobiol Int 31:954-8.

Friedman M. 1937. The use of ranks avoid the assumption of normality implicit in the analysis of variance. J Am Statistic Assoc 30:6.

Gerber Y, Jacobsen SJ, Killian JM, Weston SA, Roger VL. 2006. Seasonality and daily weather conditions in relation to myocardial infarction and sudden cardiac death in Olmsted County, Minnesota, 1979 to 2002. J Am Coll Cardiol 48:287-92.

Hillis LD, Smith PK, Anderson JL, et al. 2011. 2011 ACCF/AHA Guideline for Coronary Artery Bypass Graft Surgery. A report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines. Developed in collaboration with the American Association for Thoracic Surgery, Society of Cardiovascular Anesthesiologists, and Society of Thoracic Surgeons. J Am Coll Cardiol 58:e123-210.

Holly EA, Whittemore AS, Aston DA, Ahn DK, Nickoloff BJ, Kristiansen JJ. 1989. Anal cancer incidence: genital warts, anal fissure or fistula, hemorrhoids, and smoking. J Natl Cancer Inst 81:1726-31.

Horan JT, Francis CW, Falsey AR, Kolassa J, Smith BH, Hall WJ. 2001. Prothrombotic changes in hemostatic parameters and C-reactive protein in the elderly with winter acute respiratory tract infections. Thromb Haemost 85:245-9.

Hosmer DW, Lemeshow S, Sturdivant RX. 2013. Applied Logistic Regression. Wiley.

Kaul TK, Fields BL, Riggins SL, Dacumos GC, Wyatt DA, Jones CR. 1995. Coronary artery bypass grafting within 30 days of an acute myocardial infarction. Ann Thorac Surg May 59:1169-76.

Keatinge WR, Coleshaw SR, Cotter F, Mattock M, Murphy M, Chelliah R. 1984. Increases in platelet and red cell counts, blood viscosity, and arterial pressure during mild surface cooling: factors in mortality from coronary and cerebral thrombosis in winter. Br Med J (Clin Res Ed) 289:1405-8.

Kjaergard H, Nielsen PH, Andreasen JJ, et al. 2004. Coronary artery bypass grafting within 30 days after treatment of acute myocardial infarctions with angioplasty or fibrinolysis - a surgical substudy of DANAMI-2. Scand Cardiovasc J 38:143-6.

Konuralp C, Ketenci B, Ozay B, et al. 2002. Effects of seasonal variations on coronary artery surgery. Heart Surg Forum 5:388-92.

Kriszbacher I, Boncz I, Koppan M, Bodis J. 2008. Seasonal variations in the occurrence of acute myocardial infarction in Hungary between 2000 and 2004. Int J Cardiol 129:251-4.

Little RJ, D’Agostino R, Cohen ML, et al. 2012. The prevention and treatment of missing data in clinical trials. N Engl J Med 367:1355-60.

Ma Y, Olendzki BC, Li W, et al. 2006. Seasonal variation in food intake, physical activity, and body weight in a predominantly overweight population. Eur J Clin Nutr 60:519-28.

Mahmoud KD, Lennon RJ, Ting HH, Rihal CS, Holmes DR, Jr. 2011. Circadian variation in coronary stent thrombosis. JACC Cardiovasc Interv 4:183-90.

Marchant B, Ranjadayalan K, Stevenson R, Wilkinson P, Timmis AD. 1993. Circadian and seasonal factors in the pathogenesis of acute myocardial infarction: the influence of environmental temperature. Br Heart J 69:385-7.

Master AM, Dack S, Jaffe HL. 1937. Factors and events associated with onset of coronary artery throbosis. JAMA 109:7.

McMahon TJ, Hood JS, Nossaman BD, Kadowitz PJ. 1993. Analysis of responses to serotonin in the pulmonary vascular bed of the cat. J Appl Physiol (1985) 75:93-102.

Merriam PA, Ockene IS, Hebert JR, Rosal MC, Matthews CE. 1999. Seasonal variation of blood cholesterol levels: study methodology. J Biol Rhythms 14:330-9.

Morris PJ. 2012. Heart disease and stroke in North Carolina. N C Med J 73:448.

Ockene IS, Chiriboga DE, Stanek EJ, 3rd, et al. 2004. Seasonal variation in serum cholesterol levels: treatment implications and possible mechanisms. Arch Intern Med 164:863-70.

Roy P, de Labriolle A, Hanna N, et al. 2009. Requirement for emergent coronary artery bypass surgery following percutaneous coronary intervention in the stent era. Am J Cardiol 103:950-3.

Scherlag BJ, Patterson E, Lazzara R. 1990. Seasonal variation in sudden cardiac death after experimental myocardial infarction. J Electrocardiol 23:223-30.

Schneider A, Schuh A, Maetzel FK, Ruckerl R, Breitner S, Peters A. 2008. Weather-induced ischemia and arrhythmia in patients undergoing cardiac rehabilitation: another difference between men and women. Int J Biometeorol 52:535-47.

Spencer FA, Goldberg RJ, Becker RC, Gore JM. 1998. Seasonal distribution of acute myocardial infarction in the second National Registry of Myocardial Infarction. J Am Coll Cardiol 31:1226-33.

Stewart S, McIntyre K, Capewell S, McMurray JJ. 2002. Heart failure in a cold climate. Seasonal variation in heart failure-related morbidity and mortality. J Am Coll Cardiol 39:760-6.

Stone GW, Brodie BR, Griffin JJ, et al. 2000. Role of cardiac surgery in the hospital phase management of patients treated with primary angioplasty for acute myocardial infarction. Am J Cardiol 85:1292-6.

Ware JH, Harrington D, Hunter DJ, D’Agostino RB. 2012. Missing Data. N Engl J Med 367:1353-4.

Woodhouse PR, Khaw KT, Plummer M, Foley A, Meade TW. 1994. Seasonal variations of plasma fibrinogen and factor VII activity in the elderly: winter infections and death from cardiovascular disease. Lancet 343:435-9.

Published

2016-03-31

How to Cite

Efird, J. T., Griffin, W. F., Davies, S. W., O’Neal, W. T., Crane, P. B., Kindell, L. C., O’Neal, J. B., Chitwood, Jr., W. R., & Kypson, A. P. (2016). Seasonal Incidence of Emergent Coronary Artery Bypass Grafting Surgery. The Heart Surgery Forum, 19(2), E048-E053. https://doi.org/10.1532/hsf.1277

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