TY - JOUR
T1 - Trends in coronary artery bypass surgery
T2 - Impact on early outcomes
AU - Salick, Muhammad Musa
AU - Qadir, Irfan
AU - Perveen, Shazia
AU - Furnaz, Shumaila
AU - Sharif, Hasanat
PY - 2013/8
Y1 - 2013/8
N2 - Background: improvements in nonsurgical revascularization have left a group of higher-risk patients presenting for operation in a later stage of coronary artery disease. We undertook this study to analyze temporal changes in demographic and clinical profiles and outcomes of cardiac surgical patients. Methods: we identified and retrieved preoperative, intraoperative, and postoperative variables for 3064 consecutive patients who underwent myocardial revascularization at the Aga Khan University Hospital between 2006 and 2011. Mortality and morbidity outcomes were compared using univariate and multivariate analyses. Results: mean age, prevalence of left ventricular systolic dysfunction, unstable angina, mean number of occluded vessels, and arrhythmias at presentation increased steadily over time. The prevalence of diabetes, chronic lung disease, peripheral vascular disease, prior stroke, prior myocardial infarction, and left main disease declined. Operative mortality did not change significantly (3.5% vs. 3.8%, p = 0.512). Determinants of operative mortality included older age, female sex, renal insufficiency, left ventricular systolic dysfunction, and longer bypass and crossclamp times. Conclusion: coronary operations are increasingly performed in higher-risk patients with greater comorbidities. Despite this, operative mortality has not increased.
AB - Background: improvements in nonsurgical revascularization have left a group of higher-risk patients presenting for operation in a later stage of coronary artery disease. We undertook this study to analyze temporal changes in demographic and clinical profiles and outcomes of cardiac surgical patients. Methods: we identified and retrieved preoperative, intraoperative, and postoperative variables for 3064 consecutive patients who underwent myocardial revascularization at the Aga Khan University Hospital between 2006 and 2011. Mortality and morbidity outcomes were compared using univariate and multivariate analyses. Results: mean age, prevalence of left ventricular systolic dysfunction, unstable angina, mean number of occluded vessels, and arrhythmias at presentation increased steadily over time. The prevalence of diabetes, chronic lung disease, peripheral vascular disease, prior stroke, prior myocardial infarction, and left main disease declined. Operative mortality did not change significantly (3.5% vs. 3.8%, p = 0.512). Determinants of operative mortality included older age, female sex, renal insufficiency, left ventricular systolic dysfunction, and longer bypass and crossclamp times. Conclusion: coronary operations are increasingly performed in higher-risk patients with greater comorbidities. Despite this, operative mortality has not increased.
KW - Coronary artery bypass
KW - Pakistan
KW - coronary disease
KW - myocardial revascularization
KW - treatment outcome
UR - http://www.scopus.com/inward/record.url?scp=84882997728&partnerID=8YFLogxK
U2 - 10.1177/0218492312454277
DO - 10.1177/0218492312454277
M3 - Article
C2 - 24570520
AN - SCOPUS:84882997728
SN - 0218-4923
VL - 21
SP - 402
EP - 408
JO - Asian Cardiovascular and Thoracic Annals
JF - Asian Cardiovascular and Thoracic Annals
IS - 4
ER -