Short- and long-term survival after isolated coronary artery bypass grafting, the impact of gender and age

Nuru, Abdul; Weltzien, Joachim; Sandvik, Leiv; Tønnessen, Theis; Bjørnstad, Johannes L.

doi:10.1080/14017431.2019.1646430

Cited by 17 publications

(6 citation statements)

References 19 publications

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“…Awan and associates [ 25 ] found that low ejection fraction is an independent risk factor for mortality in patients undergoing isolated CABG. Similar to our study, Nuru and colleagues [ 26 ] found that the risk of CABG increased in older patients. These results indicate that patient-related risk factors play a significant role in determining the long-term outcomes after CABG.…”

Section: Discussionsupporting

confidence: 92%

Predictors of Outcomes After Coronary Artery Bypass Grafting: The Effect of Concomitant Mitral Repair

Marghalani¹,

AlٍRahimi²,

Baeshen³

et al. 2023

Cureus

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Background Ischemic mitral regurgitation (IMR) or functional MR intensity with or without repair increases the risk of coronary artery bypass grafting (CABG), and if the contaminant is undertaken, it doubles the risk of the surgery. This study aimed to characterize patients with concomitant CABG and mitral valve repair (MVR) and assess the surgical and long-term outcomes. Methods We conducted a cohort study from 2014 to 2020 on 364 patients who underwent CABG. A total of 364 patients were enrolled and divided into two groups. Group I (n= 349) included patients with isolated CABG, and Group II included patients who underwent CABG with concomitant mitral valve repair (MVR) (n= 15). Results Regarding preoperative presentation, most patients were male: 289 (79.40%), hypertensive 306 (84.07%), diabetic 281 (77.20%), dyslipidemic 246 (67.58%), presenting with NYHA classes III-IV: 200 (54.95%), and upon angiography, found to have the three-vessel disease: 265 (73%). Regarding their age mean± SD and Log EuroSCORE median (Q1-Q3), they had a mean age of 60.94± 10.60 years and a median score of 1.87 (1.13-3.19). The most prevalent postoperative complications were low cardiac output 75 (20.66%), acute kidney injury (AKI) 63 (17.45%), respiratory complications 55 (15.32%), and atrial fibrillation (AF) 55 (15.15%). Regarding long-term outcomes, most patients reported class I NYHA 271 (83.13%) and an echocardiographic decrease in MR severity. Patients with a CABG + MVR were significantly younger (53.93± 15.02 vs. 61.24± 10.29 years; P= 0.009), had a lower ejection fraction (33.6 [ 25 -50] vs. 50 [43-55] %; p= 0.032), and had a higher prevalence of LV dilation (32 [9.17%]). EuroSCORE was significantly higher in patients with mitral repair (3.59 [1.54-8.63] vs. 1.78 (1.13-3.11); P= 0.022). The mortality percentage was higher with MVR but did not attain statistical significance. Intraoperative CPB and ischemic durations were longer in the CABG + MVR group. Furthermore, neurological complications were higher in patients with mitral repair (4 (28.57%) vs. 30 (8.65%), P= 0.012). The study’s follow-up duration median was 24 (9-36) months. The composite endpoint occurred more frequently in older patients (HR: 1.05 [95% CI: 1.02-1.09]; 0.001), patients with low ejection fraction (HR: 0.96 [95% CI: 0.93-0.99]; P= 0.006) and in patients with preoperative myocardial infarction (MI) (HR: 2.3 [95%: 1.14- 4.68]; P= 0.021). Conclusion Most IMR patients benefited from CABG and CABG + MVR, as evident by NYHA class and echocardiographic follow-up. CABG + MVR had a higher Log EuroSCORE risk with increased intraoperative cardiopulmonary bypass (CPB) and ischemic durations, which may have played a role in increasing the incidence of postoperative neurological complications. On follow-up, no differences were reported between the two groups. However, age, ejection fraction, and a history of preoperative MI were identified as factors affecting the ...

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Section: Discussionsupporting

confidence: 92%

Predictors of Outcomes After Coronary Artery Bypass Grafting: The Effect of Concomitant Mitral Repair

Marghalani¹,

AlٍRahimi²,

Baeshen³

et al. 2023

Cureus

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“…The 5-year mortality in patients undergoing cardiac surgery ranges between 8.2% and 11.4% [15,24,25]. According to the literature, the significant factors that affect the long-term prognosis in patients undergoing CABG include age, sex, COPD, peripheral vascular disease, diabetes, renal failure, reoperation, post-operative LVEF, myocardial infarction, post-operative bleeding and infection [15,26]. Our multivariable analysis showed that the following were independent risk factors for an increased 10-year mortality in the patients undergoing CABG included in the present study: older age, peripheral artery disease, reduced post-operative LVEF, post-operative myocardial infarction and post-operative infection.…”

Section: Discussionmentioning

confidence: 99%

Impact of Post-Operative Infection after CABG on Long-Term Survival

Żukowska¹,

Kaczmarczyk

Listewnik

et al. 2023

JCM

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Coronary artery bypass grafting (CABG) is one of the most common cardiac surgical procedures. It is commonly known that post-operative infection has a negative impact on the patient’s short-term treatment outcomes and long-term prognosis. The aim of the present study was to assess the impact of perioperative infection on 5-year and 10-year survival in patients undergoing elective on-pump CABG surgery. The present prospective observational study was carried out between 1 July 2010 and 31 August 2012 among patients undergoing cardiac surgery at our centre. Infections were identified according to the ECDC definitions. We initially assessed the incidence of infection and its relationship with the parameters analysed. We then analysed the effect of particular parameters, including infection, on 5-year and 10-year survival after surgery. We also analysed the impact of particular types of infection on the risk of death within the period analysed. The significant risk factors for reduced survival were age (HR 1.05, CI 1.02–1.07), peripheral artery disease (HR 1.99, CI 1.28–3.10), reduced LVEF after surgery (HR 0.96, CI 0.94–0.99), post-operative myocardial infarction (HR 1.45, CI 1.05–2.02) and infection (HR 3.10, CI 2.20–4.28). We found a strong relationship between post-operative infections and 5-year and 10-year mortality in patients undergoing CABG. Pneumonia and BSI were the only types of infection that were found to have a significant impact on increased long-term mortality after CABG surgery.

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“…The role of sex in short- and long-term survival after CABG is unclear. Some studies have reported longer survival for women than for men after CABG [ 26 ], while others have found the opposite [ 27 ]. Moreover, one study [ 21 ] reported higher mortality for women within 1 year after CABG, but higher mortality for men between 1 and 7 years after CABG.…”

Section: Discussionmentioning

confidence: 99%

Predictors of Premature Mortality Following Coronary Artery Bypass Grafting: An Iranian Single-Centre Study

Pakrad,

Shiri,

Mozayani Monfared

et al. 2023

Healthcare

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Modifiable risk factors play an important role in the premature mortality among patients undergoing coronary artery bypass grafting (CABG). The aim of this study was to examine the factors that influence the early death of patients who had CABG. We conducted a prospective cohort study and followed 2863 patients after their CABG, and collected data on their characteristics and blood tests. We used the Cox proportional hazards regression model in Stata, version 16, to identify the predictors of early mortality. Out of 2863 patients, 162 died during the follow-up period. The survival rate was 99.2% within the first three days after the surgery, 96.2% from the fourth day to the end of the first year, 94.9% at the end of the second year, and 93.6% at the end of the third year. After adjusting for confounding factors, we found that older age (hazard ratio [HR] 1.05, 95% CI 1.02, 1.08 for one year increase in age), obesity (HR 2.16, 95% CI 1.25, 3.72), ejection fraction < 50% (HR 1.61, 95% CI 1.06, 2.44), number of rehospitalizations (HR 2.63, 95% CI 1.35, 5.12 for two or more readmissions), history of stroke (HR 2.91, 95% CI 1.63, 5.21), living in rural areas (HR 1.58, 95% CI 1.06, 2.34), opium use (HR 2.08, 95% CI 1.40, 3.09), and impaired glomerular filtration rate increased the risk of early death after CABG, while taking a beta-blocker (HR 0.59, 95% CI 0.38, 0.91) reduced the risk. We conclude that modifiable risk factors such as excess body mass, high blood glucose, opium use, and kidney dysfunction should be monitored and managed in patients who had CABG to improve their survival outcomes.

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Short- and long-term survival after isolated coronary artery bypass grafting, the impact of gender and age

Cited by 17 publications

References 19 publications

Predictors of Outcomes After Coronary Artery Bypass Grafting: The Effect of Concomitant Mitral Repair

Predictors of Outcomes After Coronary Artery Bypass Grafting: The Effect of Concomitant Mitral Repair

Impact of Post-Operative Infection after CABG on Long-Term Survival

Predictors of Premature Mortality Following Coronary Artery Bypass Grafting: An Iranian Single-Centre Study

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