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A Surgical Model of Heart Failure with Preserved Ejection Fraction in Tibetan Minipigs
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Prognostic factors of surgical management for heart failure patients with reduced left ventricular ejection fraction

Mahmoud Yousef Ibrahim Abuharb1, Liu Kaiwen1, Huang Zhuhui1

  • 1Capital Medical University Affiliated Anzhen Hospital, Cardiovascular Surgery Department, 100029, China, Beijing.

Heliyon
|March 4, 2024
PubMed

Insights

Coronary artery bypass grafting (CABG) outcomes for heart failure patients with reduced ejection fraction are influenced by specific risk factors. Older age, diabetes, renal insufficiency, and prior PCI increase adverse events post-CABG.

Area of Science:

  • Cardiology
  • Cardiac Surgery
  • Vascular Surgery

Background:

  • Coronary artery disease (CAD) management includes pharmaceutical and surgical options.
  • Coronary artery bypass grafting (CABG) is preferred for CAD patients with low ejection fraction (EF) due to better outcomes.
  • Heart failure with reduced ejection fraction (HFrEF) presents unique challenges in surgical candidates.

Purpose of the Study:

  • To identify factors associated with poor outcomes after CABG in HFrEF patients.
  • To compare outcomes between on-pump CABG (ONCAB) and off-pump CABG (OPCAB) in this population.
  • To determine predictors of major cardiovascular and cerebrovascular adverse events (MACCE) post-CABG.

Main Methods:

  • Retrospective review of 500 CAD patients with LVEF ≤40% undergoing ONCAB or OPCAB.
  • Analysis of clinical and surgical data, including postoperative mortality, morbidity, and MACCE.
  • Utilized univariate and multivariate COX regression to identify risk factors.

Main Results:

  • 64 out of 500 patients (12.8%) experienced MACCE.
  • Univariate analysis identified age ≥65, diabetes, and renal insufficiency as risk factors.
  • Multivariate analysis added previous percutaneous coronary intervention (PCI) as a significant risk factor.

Conclusions:

  • Age, diabetes, preoperative renal insufficiency, and prior PCI are significant predictors of MACCE post-CABG in HFrEF patients.
  • These findings aid in risk stratification and patient selection for CABG.
  • Optimizing preoperative conditions may improve outcomes for these high-risk patients.
Abstract

Keywords:
Heart failureHeart functionLVEFONCABOPCABRetrospective

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