Opin vísindi

Long-term outcome of surgical revascularisation in patients with reduced left ventricular ejection fraction-a population based cohort study

Long-term outcome of surgical revascularisation in patients with reduced left ventricular ejection fraction-a population based cohort study


Title: Long-term outcome of surgical revascularisation in patients with reduced left ventricular ejection fraction-a population based cohort study
Author: Brynjarsdóttir, Helga B
Johnsen, Árni
Heimisdóttir, Alexandra A
Heiðarsdottir, Sunna Rún
Jeppsson, Anders
Sigurðsson, Martin Ingi
Guðbjartsson, Tómas
Date: 2022-04-21
Language: English
Scope:
University/Institute: Landspitali - The National University Hospital of Iceland
Department: Perioperative Services
Faculty of Medicine
Cardio-Vascular Center
Series: Interactive Cardiovascular and Thoracic Surgery; ()
ISSN: 1569-9293
DOI: https://doi.org/10.1093/icvts/ivac095
Subject: Hjarta- og lungnaskurðlæknisfræði; Svæfinga- og gjörgæslulæknisfræði; Surgical revascularization; coronary artery bypass grafting (CABG); long term outcome; reduced left ventricular ejection fraction; risk factors; survival
URI: https://hdl.handle.net/20.500.11815/3243

Show full item record

Citation:

Brynjarsdóttir , H B , Johnsen , Á , Heimisdóttir , A A , Heiðarsdottir , S R , Jeppsson , A , Sigurðsson , M I & Guðbjartsson , T 2022 , ' Long-term outcome of surgical revascularisation in patients with reduced left ventricular ejection fraction-a population based cohort study ' , Interactive Cardiovascular and Thoracic Surgery . https://doi.org/10.1093/icvts/ivac095

Abstract:

BACKGROUND: Surgical revascularization is an established indication for patients with advanced coronary artery disease and reduced left ventricular ejection fraction (LVEF). Long-term outcomes for these patients are not well defined. We studied the long-term outcomes of patients with ischaemic cardiomyopathy who underwent surgical revascularization in a well-defined nationwide cohort. MATERIALS AND METHODS: A retrospective study on 2,005 patients that underwent isolated coronary artery bypass grafting (CABG) in Iceland between 2000-2016. Patients were catagorized into two groups based on their preoperative LVEF; LVEF ≤35% (n = 146, median LVEF 30%) and LVEF >35% (n = 1859, median LVEF 60%). Demographics and major adverse cardiac and cerebrovascular events (MACCE), were compared between groups along with cardiac-specific and overall survival. Mean follow-up was 7.6 years. RESULTS: Demographics were similar in both groups regarding age, gender, and most cardiovascular risk factors. However, patients with LVEF ≤35% more often had diabetes, renal insufficiency, chronic obstructive pulmonary disease and a previous history of myocardial infarction. Thirty-day mortality was four times higher (8% vs 2%, p < 0.001) in the LVEF ≤35%-group compared to controls. MACCE-free survival was 83% and 62% at 1 and 5 years for LVEF ≤35%-group compared to 94% and 82% for the control group. Overall survival was also significantly lower in the same groups, or 87% and 69% (p < 0.001) compared to 98% and 91% (p < 0.001), at 1 and 5 years respectively. CONCLUSIONS: A good long-term outcome after CABG can be expected for patients with reduced LVEF, however, their survival is still significantly inferior to patients with normal ventricular function.

Description:

© The Author(s) 2021. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery.

Files in this item

This item appears in the following Collection(s)