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Operative status and survival after coronary artery bypass grafting
Jimmy T Efird1, Wesley T O'Neal2, Stephen W Davies3
1East Carolina Heart Institute, Department of Cardiovascular Sciences, East Carolina University, Greenville, NC Center for Health Disparities, Brody School of Medicine, East Carolina University, Greenville, NC.
Insights
Black race impacts long-term survival after coronary artery bypass grafting (CABG). Black patients undergoing elective CABG had poorer survival, while elective and nonelective outcomes were similar for white patients.
Area of Science:
- Cardiovascular Surgery
- Health Disparities
- Outcomes Research
Background:
- The impact of race on long-term survival after coronary artery bypass grafting (CABG) remains understudied.
- Previous research has not adequately compared survival rates between Black and White patients undergoing CABG, stratified by operative status.
Purpose of the Study:
- To investigate and compare the long-term survival of Black versus White patients who underwent elective and nonelective coronary artery bypass grafting (CABG).
- To determine if race is a significant predictor of mortality following CABG procedures.
Main Methods:
- A retrospective analysis comparing long-term survival of Black and White patients undergoing elective and nonelective CABG between 1992 and 2011.
- Kaplan-Meier survival analysis and Cox regression modeling were used to compare survival probabilities and hazard ratios, stratified by race.
Main Results:
- The study included 13,774 patients with a median follow-up of 8.2 years.
- Black patients undergoing elective CABG demonstrated significantly lower long-term survival compared to White patients (adjusted HR = 1.4, 95% CI = 1.2-1.5).
- No significant difference in long-term survival was observed between Black and White patients undergoing nonelective CABG (adjusted HR = 1.0, 95% CI = 0.96-1.1).
Conclusions:
- Black race was identified as a statistically significant predictor of poorer long-term survival exclusively in the context of elective coronary artery bypass grafting.
- Survival outcomes after nonelective CABG did not differ significantly between Black and White patients.
Background:
The effect of race on long-term survival of patients undergoing elective and nonelective coronary artery bypass grafting (CABG) is currently unknown. The purpose of this study was to compare long-term survival between black and white CABG patients by operative status.
Methods:
Long-term survival of black versus white patients undergoing elective and nonelective CABG procedures between 1992 and 2011 was compared. Survival probabilities were computed using the Kaplan-Meier product-limit method and stratified by race. Hazard ratios (HR) and 95% confidence intervals (CI) were computed using a Cox regression model.
Results:
A total of 13,774 patients were included in this study. The median follow-up time for study participants was 8.2 years. Black patients undergoing elective CABG died sooner than whites (adjusted HR = 1.4, 95% CI = 1.2-1.5). Survival was similar between blacks and whites in the nonelective population (adjusted HR = 1.0, 95% CI = 0.96-1.1).
Conclusions:
Black race was a statistically significant predictor of long-term survival after elective but not nonelective CABG.
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