• Interventional Techniques & Devices
• Cardiology Clinical Trials

• Cardiology & Cardiovascular Medicine
• Interventional Techniques & Devices
• Cardiology Clinical Trials

Randolph Rawlins, MBBS, Advanced Cardiovascular Institute of Surgical Therapies, Cocorite, Trinidad and Tobago, and Oti Esimaje, Cardiac Surgery Resident at Advanced Cardiovascular Institute of Surgical Therapies, reported on the establishment of the West Indies Cardiac Surgery Registry. Similar to the registries of adult cardiac surgery established elsewhere, including the United States, Canada, and countries in Europe, the study supports the value of the West Indies Cardiac Surgery Registry in harnessing regional data to develop models of patient treatment and care.

Launched in 2012, the West Indies Cardiac Surgery Registry is an online database in which participation by regional health units in Trinidad and Tobago is voluntary. The Advanced Cardiovascular Institute of Surgical Therapies has entered data from 107 completed cardiac surgical procedures since the registry's inception. This study was an analysis of the 107 entries.

Triple coronary artery bypass grafting was the most common procedure (96% of patients). Three-quarters of the 107 procedures were elective. Nearly all patients (96%) received at least 1 arterial graft, along with a left internal mammary artery graft to the left anterior descending coronary artery.

The majority of the patients (81%) were men. Three-quarters of the patients were South Asian. Ages ranged from 34 to 84 years, and body mass index ranged from 18 to 36 kg/m². The prevalence of diabetes was 50%. Treatment for diabetes consisted predominantly of oral medications to lower blood glucose (63%), followed by insulin (31%) and diet modification (6%).

Smokers constituted almost half of patients, with 14% being current smokers (smoking within the prior year). The majority of the patients (60%) had hypertension. Twenty percent of the total patients had experienced prior coronary events. Five percent of the patients had carotid disease, claudication, or previous stroke or aortic aneurysm. Sixty-four percent of the patients were receiving β-blockers, and 92% were on statin therapy. Prior to surgery, nearly all patients (95%) were not receiving aspirin or clopidogrel bisulfate, and hemoglobin levels exceeded 12 g/dL in ≥ 90% of patients (Figure 1).

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Figure 1.

Hemoglobin Concentration Prior to Surgery

Reproduced with permission from R Rawlins, MBBS.

According to Dr. Rawlins, this sort of information highlights the value of a surgical registry in general and the West Indies Cardiac Surgery Registry in particular. Clarification of patient attributes is essential to supporting sound clinical decisions.

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