Brynjarsdóttir, Helga BJohnsen, ÁrniHeimisdóttir, Alexandra AldísHeiðarsdottir, Sunna RúnJeppsson, AndersSigurðsson, Martin IngiGuðbjartsson, Tómas2025-11-202025-11-202022-08-03Brynjarsdóttir, H B, Johnsen, Á, Heimisdóttir, A A, Heiðarsdottir, S R, Jeppsson, A, Sigurðsson, M I & Guðbjartsson, T 2022, 'Long-term outcome of surgical revascularization in patients with reduced left ventricular ejection fraction-a population-based cohort study', Interactive Cardiovascular and Thoracic Surgery, vol. 35, no. 3. https://doi.org/10.1093/icvts/ivac0951569-92935086800693acea15-6cef-4ebd-8bee-0b7f2de42f143544569685137134912unpaywall: 10.1093/icvts/ivac095https://hdl.handle.net/20.500.11815/6718© The Author(s) 2022. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery.OBJECTIVES: 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 2005 patients that underwent isolated coronary artery bypass grafting in Iceland between 2000 and 2016. Patients were categorized 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 were compared between groups along with cardiac-specific and overall survival. The median 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 4 times higher (8% vs 2%, P < 0.001) in the LVEF ≤35%-group compared to controls. Overall survival was significantly lower in the LVEF ≤35%-group compared to controls, at 1 year (87% vs. 98%, P < 0.001) and 5 years (69% vs. 91%, P < 0.001). In multivariable analysis LVEF ≤35% was linked to inferior survival with an adjusted hazard ratio of 2.0 (95%-CI 1.5 - 2.6, p<0.001). CONCLUSIONS: A good long-term outcome after coronary artery bypass grafting can be expected for patients with reduced LVEF, however, their survival is still significantly inferior to patients with normal ventricular function.606310eninfo:eu-repo/semantics/openAccessSurgical revascularizationcoronary artery bypass grafting (CABG)long term outcomereduced left ventricular ejection fractionrisk factorssurvivalReduced left ventricular ejection fractionLong-term outcomeCoronary artery bypass graftingSurvivalRisk factorsVentricular Dysfunction, LeftVentricular Function, LeftHumansTreatment OutcomeCoronary Artery DiseaseStroke VolumeRetrospective StudiesCohort StudiesCardiology and Cardiovascular MedicinePulmonary and Respiratory MedicineSurgerySDG 3 - Good Health and Well-being/dk/atira/pure/researchoutput/researchoutputtypes/contributiontojournal/article10.1093/icvts/ivac095