[Coronary artery bypass grafting for elderly with unprotected left main coronary artery disease: a clinical analysis]
Yu Pan1, Fang Chen, Ya-wei Luo
1Beijing Anzhen Hospital, Capital Medical University, Beijing, China.
Insights
Elderly patients with unprotected left main coronary artery disease (ULMCA) have more severe coronary lesions. Coronary artery bypass grafting (CABG) remains a safe and effective treatment for this population.
Area of Science:
- Cardiovascular Surgery
- Geriatric Cardiology
- Interventional Cardiology
Context:
- Unprotected left main coronary artery disease (ULMCA) poses significant risks.
- Coronary artery bypass grafting (CABG) is a primary revascularization strategy.
- Assessing outcomes in elderly patients is crucial due to age-related comorbidities.
Purpose:
- To investigate the clinical features and prognosis of elderly patients undergoing CABG for ULMCA.
- To compare outcomes between elderly (≥65 years) and non-elderly (<65 years) patients with ULMCA.
- To determine if age impacts the safety and efficacy of CABG in ULMCA.
Summary:
- Retrospective analysis of 176 ULMCA patients undergoing CABG.
- Elderly patients exhibited higher HDL-C, lower LDL-C, and more severe coronary stenosis, including multi-vessel disease and chronic total occlusion.
- No significant differences in major adverse cardiac and cerebral events (MACCE), mortality, or infarction rates were observed between age groups.
Impact:
- CABG is a safe and effective therapy for elderly patients with ULMCA, despite more severe coronary lesions.
- Findings support CABG as a viable option for older adults with complex coronary artery disease.
- Highlights the need for tailored risk assessment and management in geriatric cardiovascular surgery.
Objective:
To study the correlation between the clinical features and the prognosis in elderly patients with unprotected left main coronary artery disease (ULMCA) after coronary artery bypass grafting (CABG).
Methods:
The clinical parameters and prognosis data from 176 patients received CABG for ULM were retrospectively analyzed for comparison of elderly (age≥65) and against non-elderly (age < 65).
Results:
The elderly patients were found to have significantly higher level of blood high density lipoprotein cholesterin (HDL-C, mmol/L: 28.36 ± 17.20 vs. 13.68 ± 7.78, P < 0.01), lower level of blood low density lipoprotein cholesterin (LDL-C, mmol/L: 1.21 ± 0.77 vs. 2.48 ± 1.27, P < 0.01) and higher level of coronary stenosis [(94.56 ± 8.01)% vs. (87.96 ± 11.10)%, P < 0.01]. The incidence of multi-vessel disease (75.9% vs. 58.1%, P < 0.05) and chronic total occlusion (55.4% vs. 29.0%, P < 0.05) were both significantly higher in the elderly. No significant difference was found between the two groups in major adverse cardiac and cerebral events (MACCE), cerebral infarction, myocardial infarction, cardiac mortality, and total mortality (16.9% vs 17.2%, 3.6% vs 3.2%, 3.6% vs 5.4%, 6.0% vs 9.7%, and 12.0% vs 8.6%, all P > 0.05).
Conclusion:
In the elderly ULMCA patients the coronary lesions are more severe, but CABG is still a safe and efficient therapy for these patients.
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