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Published on: March 27, 2018
Five-Year Mortality among Survivors of Coronary Artery Bypass Graft Surgery: A Retrospective Study from a Tertiary
Eduardo Martelli Moreira1,2, Bernadette Cunha Waldvogel3, Eduardo Bello Martins1,4
1Instituto do Coração do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, SP - Brasil.
Insights
This study found moderate five-year mortality rates after Coronary Artery Bypass Graft (CABG) surgery in Brazil. Key risk factors for death include age, diabetes, and heart function, informing better patient care.
Area of Science:
- Cardiovascular Surgery Outcomes
- Public Health Policy
- Clinical Practice Guidelines
Background:
- Limited long-term outcome data for Coronary Artery Bypass Graft (CABG) surgery in Brazil.
- Essential data for informing public health policies and clinical practice.
- Need for comprehensive mortality analysis post-CABG.
Purpose of the Study:
- Estimate five-year all-cause and cause-specific mortality rates in CABG patients.
- Identify significant risk factors associated with mortality post-CABG.
- Provide data to guide clinical decision-making and public health strategies.
Main Methods:
- Retrospective analysis of 6,933 patients undergoing CABG (2007-2018).
- Utilized government databases for mortality data retrieval up to 2018.
- Statistical significance level set at 5% for analysis.
Main Results:
- Cohort: 4,854 men (72%), median age 63 years; 43% with diabetes, 29% with chronic kidney disease.
- Overall 5-year all-cause mortality: 12.9%; cardiovascular mortality: 5.7%.
- Leading causes of cardiovascular death: ischemic heart disease (57.3%) and cerebrovascular disease (16.6%).
Conclusions:
- Patients undergoing CABG at a tertiary center show moderate five-year mortality rates.
- Identified prognostic factors include age, diabetes, kidney function, lipid profile, cardiac function, and surgical approach.
- Findings support risk stratification and improved postoperative management strategies for CABG patients.
Background:
Long-term outcome data following Coronary Artery Bypass Graft (CABG) surgery in Brazil remain limited, yet are essential for informing public health policies and guiding clinical practice.
Objectives:
To estimate five-year all-cause and cause-specific mortality rates in patients undergoing CABG and to identify associated risk factors.
Methods:
A retrospective analysis of 6,933 patients who underwent CABG at the Heart Institute, Faculty of Medicine, University of São Paulo, between 2007 and 2018. Mortality data up to 2018 were retrieved from government databases. A significance level of 5% was adopted.
Results:
The study cohort included 4,854 men (72%) with a median age of 63 years (IQR: 57-70). Diabetes mellitus was present in 2,984 patients (43%), and 1,918 (29%) had chronic kidney disease. During follow-up, 1,075 deaths occurred, of which 506 (47.1%) were attributed to cardiovascular causes. The 5-year all-cause mortality rate was 12.9% (95% CI: 11.9-13.9), and the cardiovascular mortality rate was 5.7% (95% CI: 5.1-6.4). The leading cause of cardiovascular death was ischemic heart disease (290 deaths, 57.3%), followed by cerebrovascular disease (84 deaths, 16.6%). Factors significantly associated with all-cause mortality included older age, diabetes mellitus, glomerular filtration rate, HDL-cholesterol, left ventricular ejection fraction, left atrial and left ventricular diastolic dimensions, urgent hospitalization, on-pump surgery, and length of hospital stay.
Conclusion:
Patients undergoing CABG at a tertiary care center exhibited moderate 5-year all-cause and cardiovascular mortality rates. These findings highlight key prognostic factors that may support risk stratification and guide postoperative management strategies.
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