Risk factors of recurrent angina pectoris and of non-fatal myocardial infarction after coronary artery bypass surgery

Abstract

The long-term results of 1025 patients, 912 men and 113 women, undergoing coronary artery bypass grafting (CABG) at the Cardiovascular Unit of Rikshospitalet, Oslo, between 1982 and 1986, were analyzed on factors associated with the return of angina pectoris and of non-fatal post CABG myocardial infarction. The closing date was 1st January 1993, with a mean follow-up time of 7.4 years. Recurrent angina pectoris was experienced by 118 (11.6%) patients and 102 (10%) patients experienced non-fatal post CABG myocardial infarction during the observation period. Altogether 30 possible risk factors were analyzed. The cumulative incidence of recurrent angina was initially low after operation, followed by a rise after 4 years. One, 5 and 10 years after the operation, survival free from angina rates were 97.8%, 91.8% and 80.6%, respectively. The cumulative incidence of post CABG myocardial infarction was also low initially, followed by a rise after 4 years. The survival free of non-fatal post CABG myocardial infarction rate was 98.9%, 96% and 83.5%, at 1, 5 and 10 years after surgery, respectively. The incremental risk factor of recurrent angina pectoris was hypertension. The independent risk factors of non-fatal post CABG myocardial infarction were hypertension and preoperative stenosis of the left-sided, versus right-sided, coronary arteries. The study emphasizes the favorable effect of coronary bypass surgery on the functional outcome in patients with symptomatic coronary artery disease.

Gender Differences in Diabetic Patients Following Coronary Artery Bypass Graft Surgery

“…Other research focused on the gender differences in morbidity and mortality in patients undergoing CABG. [8][9][10][11][12][13][14][15][16][17][18][19][20][21][22][23] When compared to males, females present at a more symptomatic and acute stage of their disease. They also present at an older age (10 to 15 years later), are more likely to undergo emergent operations, and generally have a higher incidence of DM, hypertension, unstable angina, peripheral vascular disease, and congestive heart failure.…”

“…[1][2][3][4][5][6][7] Other research focused on the influence of the female gender as an independent risk factor for perioperative morbidity and mortality, higher complication rates, and lower success rates in patients undergoing CABG. [8][9][10][11][12][13][14][15][16][17][18][19][20][21][22][23] The present study focuses on the influence of gender on different postsurgical outcomes following CABG in patients with diabetes.…”

Beyond Complete Myocardial Revascularization: Is It Important and Does It Matter?

“…As a result, the completeness of revascularization is not universally defined and therefore its influence on long‐term outcomes has not been documented. Many studies base their outcome measures on the number of diseased vessels prior to surgery and not on the number of constructed bypasses 39 , 41‐49 . Furthermore, almost all studies include patients with unspecified one‐, two‐, and three‐vessel disease.…”

“…Another issue is the lack of a uniform and accepted definition of pure long‐term follow up, further complicating outcome analysis. Studies include a wide range of follow‐up (i.e., 1 to 15 years), rather than an agreed upon minimum number of years, say 10 39 , 42‐43 , 46 , 50‐56 . Lawrie, for example, followed consecutively operated upon patients for over 10 years, 57 while others had follow‐ups between 1 months and 16.6 years 52 , 55 …”

“…Many studies base their outcome measures on the number of diseased vessels prior to surgery and not on the number of constructed bypasses. 39,[41][42][43][44][45][46][47][48][49] Furthermore, almost all studies include patients with unspecified one-, two-, and three-vessel disease. Therefore, a system-based outcome analysis visa-vis the completeness of revascularization is not feasible since "vessel" in these studies is not necessarily interchangeable or synonymous with system.…”