Predictors of contemporary coronary artery bypass grafting outcomes

Richard D. Weisel, Nancy Nussmeier, Mark F. Newman, Ronald G. Pearl, Andrew S. Wechsler, Giuseppe Ambrosio, Bertram Pitt, Robert M. Clare, Karen S. Pieper, Linda Mongero, Tammy L. Reece, Terrence M. Yau, Stephen Fremes, Philippe Menasché, Armando Lira, Robert A. Harrington, T. Bruce Ferguson

Research output: Contribution to journalArticlepeer-review

20 Scopus citations

Abstract

Objectives The study objective was to identify the predictors of outcomes in a contemporary cohort of patients from the Reduction in cardiovascular Events by acaDesine in patients undergoing CABG (RED-CABG) trial. Despite the increasing risk profile of patients who undergo coronary artery bypass grafting, morbidity and mortality have remained low, and identification of the current predictors of adverse outcomes may permit new treatments to further improve outcomes.

Results The 4 independent preoperative risk factors predictive of the composite end point were (1) a history of heart failure (odds ratio, 2.9); (2) increasing age (odds ratio, 1.033 per decade); (3) a history of peripheral vascular disease (odds ratio, 1.6); and (4) receiving aspirin before coronary artery bypass grafting (odds ratio, 0.5), which was protective. The duration of the cardiopulmonary bypass (odds ratio, 1.8) was the only intraoperative variable that contributed to adverse outcomes.

Conclusions Patients who had heart failure and preserved systolic function had a similar high risk of adverse outcomes as those with low ejection fractions, and new approaches may mitigate this risk. Recognition of patients with excessive atherosclerotic burden may permit perioperative interventions to improve their outcomes. The contemporary risks of coronary artery bypass grafting have changed, and their identification may permit new methods to improve outcomes.

Original languageEnglish
Pages (from-to)2720-2726.e2
JournalJournal of Thoracic and Cardiovascular Surgery
Volume148
Issue number6
DOIs
StatePublished - Dec 1 2014

Bibliographical note

Funding Information:
The RED-CABG study was funded by Schering-Plough (subsequently Merck Sharp & Dohme Corp, Whitehouse Station, NJ).

ASJC Scopus subject areas

  • Surgery
  • Pulmonary and Respiratory Medicine
  • Cardiology and Cardiovascular Medicine

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