Outcome of patients with low ejection fraction undergoing coronary artery bypass grafting: renal function and...

Area of Science:

• Cardiology
• Cardiac Surgery
• Nephrology

Background:

• Limited data exist on the medium-term outcomes of coronary artery bypass grafting (CABG) in patients with severe left ventricular (LV) systolic dysfunction.
• Preoperative factors predicting risk in this population are not well-established, especially in the modern era.

Purpose of the Study:

• To evaluate the medium-term outcomes of isolated CABG in patients with severe LV systolic dysfunction.
• To identify preoperative factors associated with mortality in this patient group.

Main Methods:

• A cohort of 379 patients with LV ejection fraction ≤35% undergoing isolated first CABG between 1995-1999 was studied.
• Preoperative and perioperative data were collected, and patients were followed for a median of 3.8 years.
• All-cause mortality was the primary endpoint.

Main Results:

• The 30-day, 1-year, and 3-year survival rates were 94.5%, 88%, and 81%, respectively.
• Independent predictors of mortality included lower preoperative estimated glomerular filtration rate (eGFR) and older age.
• Renal dysfunction (indicated by eGFR) emerged as the strongest independent predictor of mortality.

Conclusions:

• Contemporary isolated CABG techniques provide good medium-term survival for patients with significant LV systolic dysfunction.
• Preoperative renal dysfunction is a critical factor identifying patients at highest risk of mortality after CABG.