Photo Credit: Pitchayanan Kongkaew
The following is a summary of “Long-Term Survival Following Coronary Artery Bypass Graft Surgery,” published in the January 2025 issue of Surgery by Vyas et al.
The management of stable three-vessel coronary artery disease (CAD) remains a topic of ongoing debate, particularly concerning optimal treatment strategies for patients with normal ejection fraction. This study aims to establish a survival benchmark for such patients undergoing elective coronary artery bypass grafting surgery.
Researchers analyzed data from consecutive patients with normal ejection fraction who underwent elective primary isolated CABG for triple-vessel disease across 11 diverse surgical centers between 2008 and 2020. Survival outcomes were compared with an age- and sex-matched U.S. population using data from the Centers for Disease Control and Prevention National Death Index. A mixed-effects model, with ‘hospital’ as a random effect, was employed to evaluate factors associated with all-cause mortality.
The analysis included 4,061 patients, of whom 22% (893) were female, with a median age of 68 years (interquartile range 61-74). Patients who underwent elective CABG demonstrated superior survival rates compared to the age- and sex-matched U.S. population, with relative survival improvements increasing significantly over time. Several factors were associated with increased mortality: age ≥65 years [HR] 1.71, p<0.001), male gender (HR 1.32, p=0.028), diabetes (HR 1.4, p=0.002), dialysis (HR 2.41, p=0.03), moderate or severe chronic lung disease (HR 1.68, p<0.001), and peripheral arterial disease (HR 2.05, p<0.001).
Elective CABG surgery for patients with stable three-vessel disease and normal ejection fraction is associated with improved survival compared to the general population. This benchmark provides a foundation for future research to further define the roles of surgical and medical therapies in managing this patient population.
Source: sciencedirect.com/science/article/abs/pii/S0003497525000153
