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Long-term survival of patients with low ejection fraction: surgical versus medical management

V Balu1, L Szmedra, D Dean

  • 1Cardiology Section, Buffalo Veterans' Administration Medical Center, State University of New York at Buffalo, USA.

Texas Heart Institute Journal
|January 1, 1988
PubMed

Insights

Coronary artery bypass surgery significantly improves 8-year survival for patients with ejection fractions below 25%. Surgical intervention offers better outcomes compared to medical treatment in this high-risk group.

Area of Science:

  • Cardiology
  • Cardiac Surgery
  • Clinical Outcomes Research

Background:

  • Low ejection fraction (EF) indicates compromised left ventricular function.
  • Significant coronary artery disease (CAD) poses a risk to cardiac health.
  • Evaluating long-term survival in patients with reduced EF is crucial.

Purpose of the Study:

  • To compare the 8-year survival rates of patients with significantly low ejection fractions (<25%) who underwent coronary artery bypass surgery versus medical treatment.
  • To assess the efficacy of surgical intervention in patients with compromised left ventricular function and CAD.

Main Methods:

  • Retrospective analysis of 3,592 cardiac catheterization patients from May 1974 to December 1982.
  • Identified 194 patients with significant CAD and ejection fractions < 40%.
  • Focused on 173 patients with available follow-up data, comparing 58 surgically treated patients with 115 medically treated patients.

Main Results:

  • Patients with ejection fractions < 25% showed an 8-year survival rate of 61% after coronary artery bypass surgery.
  • Medically treated patients with ejection fractions < 25% had an 8-year survival rate of 29%.
  • The difference in survival rates was statistically significant (p <.03).

Conclusions:

  • Coronary artery bypass surgery provides superior 8-year survival rates compared to medical management for patients with ejection fractions < 25%.
  • Surgical intervention is recommended for patients with compromised left ventricular function and severely reduced ejection fractions.

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