Impact of Cancer on Early Outcomes After Coronary Artery Bypass Grafting According to Cancer Stage-A Systematic...

Advances in cancer therapy have markedly expanded the population of survivors at risk for cardiovascular disease; however, evidence regarding the safety and outcomes of coronary artery bypass grafting (CABG) in patients with malignancy remains scarce. This study aimed to investigate the prognostic impact of cancer on early postoperative outcomes after CABG, including mortality, bleeding, infection, stroke, and acute kidney injury (AKI). We conducted a systematic review and meta-analysis according to the PRISMA and Cochrane guidelines. PubMed, Embase, and Cochrane Library were searched through August 2025 for studies comparing CABG outcomes in patients with and without cancer. Random-effects models generated pooled odds ratios (OR) and 95% confidence intervals (CI). Five studies were included, comprising 99,866 patients (30,818 with cancer). Early mortality was higher in cancer patients (OR 1.88; 95% CI [1.004 to 3.520]; p = 0.049) as well as bleeding (OR 1.47; 95% CI [1.018 to 2.138]; p = 0.044). Infection (OR 1.66; 95% CI [0.142 to 19.477]; p = 0.467), stroke (OR 0.85; 95% CI [0.463 to 1.563]; p = 0.370), and AKI (OR 1.08; 95% CI [0.755 to 1.545]; p = 0.545) did not significantly differ between groups. Sensitivity analysis excluding the only study restricted to non-metastatic solid tumors reduced heterogeneity (I² from 87.6% to 0%) and strengthened the mortality association (OR 2.65; 95% CI [1.94 to 3.61]; p = 0.002). In conclusion, cancer was associated with increased early mortality and bleeding after CABG, whereas infection, stroke, and AKI rates were not, and CABG prognosis may depend on cancer activity and stage, underscoring the need for individualized risk assessment and prospective validation.