Coronary Artery Bypass Grafting in advance aged patients
1Prevention of Cardiovascular Disease Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Insights
Coronary artery bypass grafting (CABG) is a safe and effective treatment for elderly patients, showing comparable early outcomes to younger patients. This study supports CABG as a viable option for older adults with acceptable risks.
Area of Science:
- Cardiology
- Geriatric Medicine
- Surgical Outcomes
Background:
- Elderly patients often present unique challenges for cardiac surgery.
- Assessing the safety and efficacy of Coronary Artery Bypass Grafting (CABG) in older populations is crucial.
Purpose of the Study:
- To compare the outcomes of CABG in elderly patients (≥75 years) versus younger patients (<75 years).
- To evaluate the impact of CABG on both early and long-term results in different age groups.
Main Methods:
- An observational case-control study involving 535 patients undergoing CABG.
- Patients were stratified into two groups: older adults (≥75 years) and younger adults (<75 years).
- Primary endpoints included in-hospital mortality and length of stay; secondary endpoints covered six-month mortality, ejection fraction, and re-hospitalization.
Main Results:
- While younger patients had higher rates of smoking and LDL cholesterol, older patients had higher prevalence of hypertension.
- In-hospital mortality showed no significant difference (2.8% vs. 5.0%, P=0.34).
- Six-month mortality was non-significantly higher in the elderly (8.1% vs. 2.1%, P=0.06), with similar rates of dual antiplatelet therapy use and no increased bleeding.
Conclusions:
- Coronary Artery Bypass Grafting (CABG) demonstrates acceptable operative risk and viable outcomes for elderly patients.
- The findings support considering CABG as a treatment option for older adults in current clinical practice.
Introduction:
This study aimed to assess the impact of coronary artery bypass grafting (CABG) on outcomes in elderly patients compared to younger patients.
Method:
An observational case-control study was conducted involving 535 patients, divided into two groups: older adults (≥75 years) and younger adults (<75 years). All patients underwent CABG following a similar protocol. The primary endpoints focused on early post-procedure outcomes, including in-hospital mortality and the duration of ICU or hospital stay. Patients were followed up for six months, and secondary study endpoints included long-term mortality, left ventricular ejection fraction, re-hospitalization rates, and repeated revascularization.
Results:
535 patients who underwent CABG were enrolled in this study. The smoking habit was significantly higher among younger adults (38.2% vs. 12.5%, P=0.001). Hypertension was more prevalent among older adults than younger adults (75% vs. 60%, P=0.044). LDL cholesterol serum levels were higher among younger adult patients (94.9±32.5 vs. 80.9±32.9, P=0.028). In-hospital death was not significantly different between younger and older adults (2.8% vs. 5.0%, P=0.34). Mortality in the six-month follow-up was non-significantly higher in the elderly (2.1% vs. 8.1%, P=0.06).A significant proportion of patients in both groups (46.9% in younger patients vs. 40% in older ones, P=0.40) received dual antiplatelet therapy (DAPT) prior to CABG due to a recent myocardial infarction and receipt of a new stent, but without increased major bleeding in both groups.
Conclusion:
CABG should be considered a viable treatment option for elderly patients with acceptable operative risk in current clinical practice.
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