[Long-term outcome of surgical revascularization in patients with ischemic heart disease and left ventricular dysfunction].

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  • Additional Information
    • Source:
      Publisher: Zhonghua yi xue hui Country of Publication: China NLM ID: 7511141 Publication Model: Print Cited Medium: Print ISSN: 0376-2491 (Print) Linking ISSN: 03762491 NLM ISO Abbreviation: Zhonghua Yi Xue Za Zhi Subsets: MEDLINE
    • Publication Information:
      Publication: Beijing : Zhonghua yi xue hui
      Original Publication: Beijing : Zhonghua yi xue hui.
    • Subject Terms:
      Myocardial Revascularization*; Coronary Artery Disease/*surgery ; Myocardial Ischemia/*surgery ; Ventricular Dysfunction, Left/*surgery; Adult ; Aged ; Aged, 80 and over ; Angina Pectoris ; Coronary Artery Bypass ; Coronary Artery Bypass, Off-Pump ; Coronary Artery Disease/mortality ; Female ; Heart Failure ; Hospital Mortality ; Humans ; Male ; Middle Aged ; Myocardial Infarction ; Myocardial Ischemia/mortality ; Proportional Hazards Models ; Risk Factors ; Survival Rate ; Treatment Outcome ; Ventricular Dysfunction, Left/mortality ; Ventricular Function, Left
    • Abstract:
      Objective: To analyze the long-term results and risk factors of surgical revascularization in patients with ischemic heart disease (IHD) and left ventricular dysfunction (LVD).
      Methods: From January 2003 to July 2013, 2 132 patients underwent coronary artery bypass grafting (CABG) in our institution. Among them, 318 patients with LVD[left ventricular ejection fraction (LVEF) ≤50%]were included in the final study. There were 26 6 male and 52 female patients with age from 36 to 83 (63±9) years old. 76 patients underwent off-pump CABG (OPCAB) and 242 patients underwent conventional CABG (CCABG). Risk factors, perioperative results and follow-up data were collected and analyzed with cox hazard ratio model.
      Results: Among 318 patients, 6 cases died of the operation with a hospital mortality of 1.9%. With follow-up time from 1 to 128(45.5±32.4)months, 25 patients were lost of follow-up, causing a follow-up rate of 92.0%. Among the 287 cases with long-term follow-up results, all-cause death, cardiogenic death and re-hospitalization due to heart failure were 14.6% (42/287), 5.9%(17/287), 14.6% (42/287), respectively. Re-revascularization rate, recurrent angina and myocardial infarction rate and cerebral incidence were 3.5%(10/287), 13.6% (39/287), 1.7%(5/287), respectively. The five-year survival rate was 85.6%. With all-cause death as the endpoint, preoperative LVEF (HR=0.943, 95%CI: 0.893-0.995, P=0.031) and perioperative implantation of IABP (HR=2.509, 95%CI: 1.051-5.992, P=0.038) emerged as the risk factors that affected the long term survival. The five-year survival rate of patients with severe LVD (LVEF≤35%) was significantly lower than that of patients with mild to moderate LVD (35%Conclusions: Preoperative LVEF and perioperative implantation of IABP had adverse effect on long-term survival of patients with IHD and LVD undergoing surgical revascularization. The long-term survival of patients with severe LVD was significantly lower than those with mild to moderate LVD. The long-term survival significantly decreased among patients undergoing peri-operative implantation of IABP.
    • Publication Date:
      Date Created: 20160428 Date Completed: 20161213 Latest Revision: 20181202
    • Publication Date:
      20231215
    • Accession Number:
      10.3760/cma.j.issn.0376-2491.2016.15.007
    • Accession Number:
      27117363