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Published on: January 28, 2020

Heart failure after myocardial revascularization: risk markers

Mauro Biffi1, Matteo Bertini, Giuseppe Boriani

  • 1Institute of Cardiology, University of Bologna, Via Massarenti 9, 40138 Bologna, Italy. mbiffi@orsola-malpighi.med.unibo.it

International Journal of Cardiology
|October 7, 2005
PubMed

Insights

Coronary artery bypass grafting (CABG) patients face heart failure risks. Pre-surgery stroke history, diabetes, and prolonged QRS duration predict this outcome, aiding risk stratification.

Area of Science:

  • Cardiology
  • Cardiac Surgery
  • Heart Failure Research

Background:

  • Patients undergoing Coronary Artery Bypass Grafting (CABG) are at risk for developing heart failure post-surgery.
  • Accurate risk stratification is crucial for identifying patients susceptible to heart failure after CABG.

Purpose of the Study:

  • To investigate the prognostic value of preoperative risk factors for heart failure in patients undergoing CABG.
  • To identify key predictors of heart failure development at one year follow-up after CABG.

Main Methods:

  • A cohort of 351 consecutive patients undergoing CABG were followed for 18 months.
  • Logistic regression analysis was used to assess the association between preoperative variables and heart failure development (>class 2).
  • Variables analyzed included: sex, age, left ventricular ejection fraction (EF), QRS duration, previous myocardial infarction (MI), history of heart failure, atrial fibrillation (AF), hypertension, hypercholesterolemia, diabetes, and previous stroke.

Main Results:

  • Heart failure >class 2 occurred in 27% of patients at follow-up.
  • Logistic regression identified a history of stroke (OR=3.94), diabetes (OR=1.98), and QRS duration (OR=1.02) as significant predictors of heart failure.
  • Patients with QRS duration ≥140 ms (10% of cohort) had a significantly higher incidence of heart failure (51% vs. 24%) compared to those with QRS <140 ms.

Conclusions:

  • Preoperative stroke history, diabetes, and QRS duration are valuable, inexpensive predictors of heart failure after CABG.
  • Risk stratification for heart failure in CABG candidates can be improved using these readily available clinical variables.
  • A small subset of patients may benefit from LV-based pacing, considered during the surgical procedure.

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