Related Experiment Videos
Late outcome of coronary artery bypass grafting in young versus older patients
I Rohrer-Gubler1, U Niederhauser, M I Turina
1Department of Surgery, University Hospital, Zurich, Switzerland.
Insights
Long-term survival after coronary artery bypass grafting is similar for young and older adults. However, younger patients require more reinterventions, highlighting the importance of graft choice and patient factors for improved outcomes.
Area of Science:
- Cardiology
- Cardiac Surgery
- Medical Research
Background:
- Compares long-term outcomes of coronary artery bypass grafting (CABG) in young patients (≤40 years) versus older patients.
- Utilizes a matched cohort design with 176 patients in each group, operated between 1976 and 1988.
Purpose of the Study:
- To evaluate and compare the long-term results of CABG in young versus older patient populations.
- To identify predictors of survival and reintervention in these distinct age groups.
Main Methods:
- Matched case-control study comparing 176 young patients (mean age 37.4 years) with 176 older patients (mean age 64.2 years).
- Matching criteria included age, sex, left ventricular ejection fraction, number of grafts, and year of operation.
- Actuarial survival rates and reintervention rates were analyzed.
Main Results:
- Younger patients had higher rates of smoking, hypercholesterolemia, unstable angina, and prior myocardial infarction, but lower rates of hypertension and diabetes.
- Actuarial survival rates at 5, 10, and 15 years were comparable between groups (92%, 86%, 72% vs. 92%, 86%, 66%).
- Young age was a significant predictor of cardiac reoperation.
Conclusions:
- Late survival after CABG is similar for young and older patients.
- Younger patients experience a higher rate of reintervention.
- Factors such as absence of unstable angina, ejection fraction >0.45, and internal mammary artery graft use predict improved survival across all age groups.
Background:
We compared long-term results of coronary artery bypass grafting between 1976 and 1988 in 176 patients 40 years old or younger with a matched control group of 176 patients 25 to 30 years older.
Methods:
Mean age was 37.4 +/- 2.7 years (+/- standard deviation) in the study group and 64.2 +/- 2.9 years in the control group. Matching criteria were age, sex, left ventricular ejection fraction, number of bypass grafts, and year of operation.
Results:
The study group had more smokers (p = 0.000) and more patients with hypercholesterolemia (p = 0.026), unstable angina (p = 0.003), and preoperative myocardial infarction (p = 0.009); fewer patients had hypertension (p = 0.000) and diabetes (p = 0.005) in this group than in the control group. The internal mammary artery was used in 31% of the study patients and in 30% of the controls. The actuarial survival rates after 5, 10, and 15 years were 92%, 86%, and 72% in the study group and 92%, 86%, and 66% in the control group (p = 0.202). Young age was a predictor of cardiac reoperation.
Conclusions:
Late survival is similar for young and older patients, but the reintervention rate is higher in the younger group. The absence of unstable angina, a left ventricular ejection fraction greater than 0.45, and the use of internal mammary artery grafts increase survival in all patients.