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Multicenter Study
. 2023 Apr 1;109(4):707-715.
doi: 10.1097/JS9.0000000000000259.

Clinical outcomes and quality of life after contemporary isolated coronary bypass grafting: a prospective cohort study

Sigrid Sandner  1 , Martin Misfeld  2   3   4   5   6 , Etem Caliskan  7   8 , Andreas Böning  9 , Jose Aramendi  10 , Sacha P Salzberg  11 , Yeong-Hoon Choi  12 , Louis P Perrault  13 , Ilker Tekin  14   15 , Gregorio P Cuerpo  16 , Jose Lopez-Menendez  17 , Luca P Weltert  18 , Johannes Böhm  19 , Markus Krane  20 , José M González-Santos  21 , Juan-Carlos Tellez  22 , Tomas Holubec  23 , Enrico Ferrari  24 , Gheorghe Doros  25 , Clara J Vitarello  26 , Maximilian Y Emmert  7   8 ; Registry Investigators; European DuraGraft Registry investigators’
Collaborators, Affiliations
Multicenter Study

Clinical outcomes and quality of life after contemporary isolated coronary bypass grafting: a prospective cohort study

Sigrid Sandner et al. Int J Surg. .

Abstract

Objectives: The objective of the European Multicenter Registry to Assess Outcomes in coronary artery bypass grafting (CABG) patients (DuraGraft Registry) was to determine clinical outcomes and quality of life (QoL) after contemporary CABG that included isolated CABG and combined CABG/valve procedures, using an endothelial damage inhibitor (DuraGraft) intraoperatively for conduit preservation. Here, we report outcomes in the patient cohort undergoing isolated CABG.

Methods: The primary outcome was the composite of all-cause death, myocardial infarction (MI), or repeat revascularization (RR) [major adverse cardiac events (MACE)] at 1 year. Secondary outcomes included the composite of all-cause death, MI, RR, or stroke [major adverse cardiac and cerebrovascular events (MACCE)], and QoL. QoL was assessed with the EuroQol-5 Dimension questionnaire. Independent risk factors for MACE at 1 year were determined using Cox regression analysis.

Results: A total of 2532 patients (mean age, 67.4±9.2 years; 82.5% male) underwent isolated CABG. The median EuroScore II was 1.4 [interquartile range (IQR), 0.9-2.3]. MACE and MACCE rates at 1 year were 6.6% and 7.8%, respectively. The rates of all-cause death, MI, RR, and stroke were 4.4, 2.0, 2.2, and 1.9%, respectively. The 30-day mortality rate was 2.3%. Age, extracardiac arteriopathy, left ventricular ejection fraction less than 50%, critical operative state, and left main disease were independent risk factors for MACE. QoL index values improved from 0.84 [IQR, 0.72-0.92] at baseline to 0.92 [IQR, 0.82-1.00] at 1 year ( P <0.0001).

Conclusion: Contemporary European patients undergoing isolated CABG have a low 1-year clinical event rate and an improved QoL.

Trial registration: ClinicalTrials.gov NCT02922088.

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Conflict of interest statement

E.C., S.S., M.M., J.A., S.P.S., Y.H.C., and A.B. are members of the Registry Advisory Committee (RAC). L.P.P. is a member of the RAC and is a consultant for Marizyme. MYE is the principal investigator of the registry, the chair of the RAC and a consultant for Marizyme. E.F. received research grants from Somahlution, a Marizyme company. Other authors have nothing to disclose.

Sponsorships or competing interests that may be relevant to content are disclosed at the end of this article.

Figures

None
Graphical abstract
Figure 1
Figure 1
Cumulative incidence of the composite primary outcome (MACE) and secondary outcome (MACCE) and their individual components at 1 year. CABG, coronary artery bypass grafting; MACE, major adverse cardiac events; MACCE, major adverse cardiac and cerebrovascular events.
Figure 2
Figure 2
Hazard ratio for MACE in a univariable and multivariable model after isolated CABG. CABG, coronary artery bypass grafting; CCS, Canadian Cardiovascular Society; HR, hazard ratio; MACE, major adverse cardiac events; NYHA, New York Heart Association.
Figure 3
Figure 3
Hazard ratio for MACCE in a univariable and multivariable model after isolated CABG. CABG, coronary artery bypass grafting; CCS, Canadian Cardiovascular Society; HR, hazard ratio; MACCE, major adverse cardiac and cerebrovascular events; NYHA, New York Heart Association.
Figure 4
Figure 4
(A) Median and IQR of the EQ-5D index values at baseline and 1 year. (B) The five dimensions of the EQ-5D at baseline and 1 year. CABG, coronary artery bypass grafting; EQ-5D, EuroQol-5 Dimension; IQR, interquartile range.
See this image and copyright information in PMC

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