Abstract | BACKGROUND: There are few data regarding medium-term outcome of coronary artery bypass grafting (CABG) in patients with severe left ventricular ( LV) systolic dysfunction, particularly in the modern era, and even less assessing preoperative factors that might identify patients at highest risk. METHODS AND RESULTS: Three hundred seventy-nine consecutive patients with LV ejection fraction < or = 35%, who underwent isolated first CABG between 1995 and 1999 were studied. Potential preoperative and perioperative predictors of outcome were recorded and patients followed-up for a median of 3.8 years. The primary study end-point was all-cause mortality. The 30-day, 1-year, and 3-year survival rates were 94.5%, 88%, and 81%, respectively. The independent predictors of mortality were preoperative estimated glomerular filtration rate (hazard ratio [HR], 0.98; 95% confidence interval [CI], 0.97 to 0.99 per mL/min/1.73 m2; P<0.001) and age (HR, 1.03; 95% CI, 1.01 to 1.06 per year; P=0.005). CONCLUSIONS: Patients with significant LV systolic dysfunction undergoing isolated CABG using contemporary techniques have a good medium-term survival. Renal dysfunction is the strongest independent predictor of mortality.
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Authors | Graham S Hillis, Kenton J Zehr, Amy W Williams, Hartzell V Schaff, Thomas A Orzulak, Richard C Daly, Charles J Mullany, Richard J Rodeheffer, Jae K Oh |
Journal | Circulation
(Circulation)
Vol. 114
Issue 1 Suppl
Pg. I414-9
(Jul 04 2006)
ISSN: 1524-4539 [Electronic] United States |
PMID | 16820610
(Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
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Chemical References |
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Topics |
- Aged
- Cardiac Output, Low
(epidemiology)
- Cohort Studies
- Comorbidity
- Coronary Artery Bypass
(statistics & numerical data)
- Creatinine
(blood)
- Female
- Follow-Up Studies
- Glomerular Filtration Rate
- Humans
- Kidney
(physiopathology)
- Kidney Failure, Chronic
(epidemiology, physiopathology)
- Male
- Middle Aged
- Mortality
- Stroke Volume
- Survival Analysis
- Survival Rate
- Treatment Outcome
- Ventricular Dysfunction, Left
(epidemiology)
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