Peripheral vascular disease as a predictor of survival after coronary artery bypass grafting: comparison with a matched general population
- PMID: 20103313
- DOI: 10.1016/j.athoracsur.2009.11.036
Peripheral vascular disease as a predictor of survival after coronary artery bypass grafting: comparison with a matched general population
Abstract
Background: The European system for cardiac operative risk evaluation, the most popular European scoring system in cardiac surgery, uses the extracardiac arteriopathy as a risk factor for early mortality. We studied the effect of peripheral vascular disease (PVD) on early and late mortality in a large group of patients undergoing isolated coronary artery bypass surgery (CABG) surgery.
Methods: During a ten-year period (January 1998 through December 2007) 10,626 patients underwent isolated CABG in our hospital. The primary endpoints of this study were early and late all-cause mortality. For each year of the study period, general population cohorts were matched with the patient groups for age and gender (expected survival).
Results: Out of 10,504 patients included in the analysis, 1,222 (11.63%) patients had PVD. The PVD was identified as an independent risk factor for late mortality (death at any time after hospital discharge) (hazard ratio of 1.67 [1.43 to 1.95], p < 0.0001), but not for early mortality (death within 30 days or before discharge) (hazard ratio of 1.06 [0.70 to 1.60], p = 0.776). Patients without PVD had a better survival than patients with PVD (log-rank p < 0.0001) and even a better survival compared to the normal Dutch population survival (p value < 0.002). The PVD patients had a worse than expected survival (log-rank p < 0.0001).
Conclusions: Peripheral vascular disease is an independent risk factor only for late mortality but not for early mortality. Compared with age-matched and sex-matched cohorts from the general Dutch population, the ten-year survival of patients with peripheral vascular disease was worse; whereas the survival of patients with no peripheral vascular disease was better.
2010 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.
Comment in
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Is remote ischemic preconditioning triggered by intermittent claudication secondary to peripheral arterial disease responsible for preventing early mortality after coronary artery bypass surgery?Ann Thorac Surg. 2011 Jan;91(1):333-4. doi: 10.1016/j.athoracsur.2010.06.049. Ann Thorac Surg. 2011. PMID: 21172560 No abstract available.
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