Favourable long-term outcome after coronary artery bypass grafting in a nationwide cohort.

• Published in: Scandinavian Cardiovascular Journal
• Main Authors: Johannesdottir, Hera, Arnadottir, Linda O, Adalsteinsson, Jonas A, Axelsson, Tomas A, Sigurdsson, Martin I, Helgadottir, Solveig, Helgason, Dadi, Gardarsdottir, Helga R, Marteinsson, Steinthor A, Geirsson, Arnar, Thorgeirsson, Gudmundur, Gudbjartsson, Tomas
• Other Authors: 1 Landspitali Univ Hosp, Dept Cardiothorac Surg, Reykjavik, Iceland Show more 2 Duke Univ Hosp, Dept Anesthesiol, Durham, NC USA Show more 3 Uppsala Univ Hosp, Dept Anaesthesiol & Intens Care, Uppsala, Sweden Show more 4 Yale Univ, Sch Med, Sect Cardiac Surg, New Haven, CT USA Show more 5 Univ Iceland, Fac Med, Reykjavik, Iceland Show more 6 Landspitali Univ Hosp, Dept Cardiol, Reykjavik, Iceland
• Format: Article in Journal/Newspaper
• Language: English
• Published: Taylor & Francis 2017
• Subjects: Kransæðasjúkdómar; Hjáveituaðgerðir; Lífsgæði; Lífslíkur; TAS12; CAR12; Adult; Aged; 80 and over; Comorbidity; Coronary Artery Bypass; Coronary Artery Disease; Female; Humans; Iceland; Internal Mammary-Coronary Artery Anastomosis; Kaplan-Meier Estimate; Male; Middle Aged; Multivariate Analysis; Myocardial Infarction; Proportional Hazards Models; Retreatment; Retrospective Studies; Risk Factors; Saphenous Vein; Stroke; Survival Rate; Time Factors; Treatment Outcome; Meier
• Online Access: http://hdl.handle.net/2336/620411; https://doi.org/10.1080/14017431.2017.1364418

To access publisher's full text version of this article click on the hyperlink below In a nationwide cohort, we analyzed long-term outcome following coronary artery bypass grafting, using the combined strategy of left internal mammary artery to the left anterior descending artery and saphenous vein as secondary graft to other coronary targets. 1,507 consecutive patients that underwent myocardial revascularization during 2001-2012 in Iceland. Mean follow-up was 6.8 years. Major adverse cardiac and cerebrovascular events were depicted using the Kaplan-Meier method. Cox-regression was used to define risk factors. Relative survival was estimated by comparing overall survival to the survival of Icelanders of the same age and gender. Mean age was 66 years, 83% were males, mean EuroSCOREst was 4.5, and 23% of the procedures were performed off-pump. At 5 years, 19.7% had suffered a major adverse cardiac or cerebrovascular event, 4.5% a stroke, 2.2% myocardial infarction, and 6.2% needed repeat revascularization. Overall 5-year survival was 89.9%, with a relative survival of 0.990. Independent predictors of major adverse cardiac and cerebrovascular events were left ventricular ejection fraction ≤30%, a previous history of percutaneous coronary intervention, chronic obstructive lung disease, chronic kidney disease, diabetes, and old age. The same variables and an earlier year of operation were predictors of long-term mortality. The long-term outcome following myocardial revascularization, using the left internal mammary artery and the great saphenous vein as conduits, is favourable and improving. This is reflected by the 5-year survival of 89.9%, deviating minimally from the survival rate of the general Icelandic population, together with a freedom from major adverse cardiac and cerebrovascular events of 80.3%. Landspitali University Hospital Research Fund University of Iceland Research Fund Helga Gudmundsdottir and Sigurlidi Kristjansson Memorial Fund