Related Experiment Video
Updated: Apr 5, 2026
Surgical Swine Model of Chronic Cardiac Ischemia Treated by Off-Pump Coronary Artery Bypass Graft Surgery
Published on: March 27, 2018
Midterm Outcome of Coronary Artery Bypass Grafting in Young Patients: A Multicenter Italian Study
Stefano Rosato1, Fausto Biancari2, Paola D'Errigo1
1National Centre for Epidemiology, Surveillance and Health Promotion, Istituto Superiore di Sanità, Rome, Italy.
Insights
Younger patients (<50 years) undergoing coronary artery bypass grafting (CABG) show excellent long-term survival and fewer major adverse cardiac events. This suggests coronary artery disease in young individuals does not necessarily follow a more aggressive course.
Area of Science:
- Cardiovascular Surgery
- Cardiac Surgery Outcomes
- Coronary Artery Disease
Background:
- Coronary artery bypass grafting (CABG) in young patients necessitates durable outcomes to prevent future cardiovascular events.
- Evaluating late outcomes in patients under 50 undergoing CABG is crucial for long-term patient management.
- Comparison of outcomes between younger and older patients after CABG provides insights into disease progression and treatment efficacy.
Purpose of the Study:
- To compare the late outcomes of coronary artery bypass grafting (CABG) in patients younger than 50 years versus older patients.
- To assess the durability of myocardial revascularization in young individuals.
- To determine if premature coronary artery disease in young patients follows a more aggressive clinical course.
Main Methods:
- Survival analysis of a pooled, multicenter, prospective cohort of patients undergoing CABG.
- Propensity score-adjusted analysis to compare outcomes between age groups.
- Propensity score-matched analysis to evaluate 7-year outcomes including survival and freedom from adverse events.
Main Results:
- Patients under 50 (5% of cohort) had lower prevalence of comorbidities but higher rates of recent myocardial infarction and emergency surgery.
- Propensity score-adjusted analysis revealed significantly lower mortality risk in patients under 50.
- In matched cohorts, patients under 50 demonstrated superior 7-year survival (95.6% vs. 81.1%) and freedom from MACCE (76.6% vs. 63.9%) compared to older patients.
Conclusions:
- Coronary artery bypass grafting (CABG) in patients under 50 years of age yields excellent late outcomes compared to older counterparts.
- Younger patients (<50) undergoing CABG experience significantly better survival and reduced major adverse cardiac and cerebrovascular events.
- The findings suggest that coronary artery disease, even at a younger age, does not inherently progress more aggressively than in older populations.
Background:
Myocardial revascularization in young patients should be durable enough to avoid new cardiovascular events or repeated revascularization procedures. The aim of this study was to evaluate the late outcomes of patients less than 50 years of age undergoing coronary artery bypass grafting (CABG) in comparison with older patients.
Methods:
This study was a survival analysis of a pooled multicenter prospective cohort of patients who underwent CABG.
Results:
Five percent of patients (572 of 11,087) were less than 50 years of age. The prevalence of female sex, pulmonary disease, diabetes, stroke, and extracardiac arteriopathy was lower compared with that in older patients. Left ventricular function was more well preserved in patients less than 50 years of age, but the prevalence of recent myocardial infarction and the need for emergency surgical intervention was significantly higher in young patients. Multiple propensity score-adjusted analysis showed that patients aged less than 50 years had a significantly lower risk of mortality, even when compared with the 50- to 59-year stratum. In the propensity score-matched population (544 pairs), patients less than 50 years of age had significantly better 7-year outcomes compared with patients aged 50 years or more: survival (95.6% versus 81.1%; p < 0.0001), freedom from stroke (97.4% versus 95.3%; p = 0.009), freedom from major adverse cardiac and cerebrovascular events (MACCE) (76.6% versus 63.9%; p = 0.002). Similar freedom from myocardial infarction (90.1% versus 90.1%; p = 0.68) and repeated revascularization (87.1% versus 87.2%; p = 0.65) was observed in patients less than 50 years of age and those older than 50 years.
Conclusions:
Patients less than 50 years of age undergoing CABG have an excellent outcome compared with elderly patients. These data indicate that despite its premature onset, coronary artery disease in young patients does not have a more aggressive course than that in older patients.
More Related Videos
Related Concept Videos
01:30Acute Coronary Syndrome III: Diagnostic Studies
01:27Coronary Artery Disease V: Interprofessional Care
01:30Coronary Artery Disease III: Clinical Manifestations
01:30Coronary Artery Disease I: Introduction