Cardiothoracic & vascular anaesthesia
Drug-Gene Interactions and Clinical Outcomes After Vascular Surgery in the Million Veteran Program
Authors' conclusion
The findings suggest that patients with DGIs at the time of vascular surgery have increased risk of cardiovascular morbidity, increased readmission, and longer LOS.
Study context
- Population
- Veterans Affairs (VA) hospital patients in the Million Veteran Program with a vascular procedure documented in VA Surgical Quality Improvement Program (VASQIP), 2011–20225,020 with a DGI
- Participants
- 10,098 patients
- Exposure
- 1, 2, or 3 or more active drug-gene interactions vs 0 drug-gene interactions (DGIs)
- Outcome
- VASQIP clinical outcomes: Length of stay (LOS), 30-day readmission, composite of MI, stroke and MINS, and 30-day postoperative death
Methodological detailsMillion Veteran Program, VASQIP registry
- Million Veteran Program
- VASQIP registry
Main finding
As reported in the abstract
LOS
Each group vs 0 DGIsAdjusted incidence rate ratio (95% CI)P value
1 DGI
1.12(1.10–1.14)
P < 0.0012 DGIs
1.22(1.19–1.25)
P < 0.0013 or more DGIs
1.40(1.35–1.44)
P < 0.001Observational data: associations, not effects.
Further findings
| Outcome | 0 DGIs | 1 DGI | 2 DGIs | 3 or more DGIs | aOR (95% CI) | P value | |
|---|---|---|---|---|---|---|---|
| 30-day readmission · 30 days1 DGI vs 0 DGIs · main outcome | 17.4% | 17.6% | 21.2% | 25.1% | 1.01 (0.90–1.14) | P = 0.84 | |
| 30-day readmission · 30 days2 DGIs vs 0 DGIs · main outcome | 1.26 (1.08–1.47) | P = 0.004 | |||||
| 30-day readmission · 30 days3 or more DGIs vs 0 DGIs · main outcome | 1.61 (1.30–1.99) | P < 0.001 | |||||
| Composite of MI, stroke and MINS1 DGI vs 0 DGIs · main outcome | 3.5% | 4.1% | 5.7% | 5.5% | 1.15 (0.91–1.45) | P = 0.24 | |
| Composite of MI, stroke and MINS2 DGIs vs 0 DGIs · main outcome | 1.62 (1.22–2.15) | P = 0.001 | |||||
| Composite of MI, stroke and MINS3 or more DGIs vs 0 DGIs · main outcome | 1.60 (1.04–2.36) | P = 0.02 | |||||
| 0.512Adjusted odds ratio (log scale) |
Original publication
Drug-Gene Interactions and Clinical Outcomes After Vascular Surgery in the Million Veteran Program. JAMA Surg. Published 1 July 2025. doi:10.
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