Coronary Artery Bypass Grafting in Young Adults
Hina Inam1,2, Abdul Ahad Sohail1,2, Aiman Aamir1,2
1Department of Cardiothoracic Surgery, The Agha Khan University Hospital, Karachi, Pakistan.
Insights
Coronary artery disease (CAD) in adults under 45 presents similar risk factors and outcomes after coronary artery bypass graft (CABG) surgery compared to older patients. This study evaluated these younger patients undergoing CABG.
Area of Science:
- Cardiology
- Cardiothoracic Surgery
- Vascular Medicine
Background:
- Coronary artery disease (CAD) is increasingly recognized in younger adults.
- Understanding risk factors and outcomes in this demographic is crucial for effective management.
- Early-onset CAD necessitates tailored clinical approaches.
Purpose of the Study:
- To identify risk factors for early-onset coronary artery disease (CAD).
- To assess the preoperative presentation, perioperative course, survival, and short-term complications in patients aged 45 years or younger undergoing coronary artery bypass graft (CABG).
Main Methods:
- An observational study was conducted at the Department of Cardiothoracic Surgery, The Aga Khan University Hospital, Karachi, Pakistan.
- Included were 134 patients aged 45 years or younger undergoing CABG, with incomplete records excluded.
- Data collected included demographics, intraoperative variables (conduits used), and postoperative morbidity/mortality.
Main Results:
- The cohort comprised 134 patients (89.6% male), with a mean age of 38.6 years.
- Three-vessel disease was the primary indication for surgery in 41.7% of patients.
- Operative mortality was 1.5%, with common risk factors including family history, diabetes, hypertension, and smoking.
Conclusions:
- Risk factors and outcomes for younger patients (<45 years) undergoing CABG are comparable to older patients.
- Findings align with existing literature on CAD in younger populations.
- Early-onset CAD management in young adults shows similar patterns to the general patient population.
Objective:
To evaluate the risk factors for early onset of coronary artery disease (CAD) and assess the preoperative presentation, perioperative course, survival, and short-term complications after coronary artery bypass graft (CABG) in patients aged 45 years or younger undergoing CABG.
Study Design:
Observational study. Place and Duration of the Study: Department of Cardiothoracic Surgery, The Aga Khan University Hospital, Karachi, Pakistan, from December 2020 to January 2021.
Methodology:
All patients aged 45 years or younger who were undergoing CABG were included in the study. Patients with incomplete medical records were excluded. Study variables included preoperative demographic information, intraoperative variables including the number and type of conduits used, and postoperative morbidity and mortality. Descriptive analysis was reported for all variables.
Results:
The study population cohort included 134 patients, of whom 120 (89.6%) were male, with a mean age of 38.6 ± 5.1 years (range: 30-45 years). The indication for surgery was 3-vessel CAD in 56 (41.7%) patients. A total of 421 grafts were constructed, with a mean of 3.14 grafts per patient. One patient died in the hospital with an overall operative mortality of 1.5%. The most common risk factors were found to be family history, the presence of diabetes mellitus, hypertension, and smoking.
Conclusion:
The risk factors and outcomes in younger patients (less than 45 years) undergoing CABG are not markedly different from those in older patients and are comparable to the existing literature.
Key Words:
Coronary artery disease, Coronary artery bypass graft, Young adults, Risk factors, Three vessel disease.
