Trends in coronary artery bypass surgery: Impact on early outcomes

Muhammad Musa Salick, Irfan Qadir, Shazia Perveen, Shumaila Furnaz, Hasanat Sharif

Research output: Contribution to journalArticlepeer-review

Abstract

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.

Original languageEnglish
Pages (from-to)402-408
Number of pages7
JournalAsian Cardiovascular and Thoracic Annals
Volume21
Issue number4
DOIs
Publication statusPublished - Aug 2013

Keywords

  • Coronary artery bypass
  • Pakistan
  • coronary disease
  • myocardial revascularization
  • treatment outcome

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