A >10% improvement in LVEF after CABG occurred in 26.4% of patients with ischemic cardiomyopathy and was associated with a 57% lower risk of all-cause mortality (HR 0.43; 95% CI 0.26-0.71).
Observational (n=549)
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Does CABG improve LVEF in patients with ischemic cardiomyopathy and LVEF <50%, and is this improvement associated with survival?
In patients with ischemic cardiomyopathy undergoing CABG, a >10% improvement in LVEF occurs in about a quarter of patients and is associated with significantly improved long-term survival.
Estimación del efecto: HR 0.43 (95% CI 0.26-0.71)
BACKGROUND: Nearly 1/3rd of patients undergoing coronary artery bypass graft surgery (CABG) have left ventricular systolic dysfunction. However, the extent, direction and implications of perioperative changes in left ventricular ejection fraction (LVEF) have not been well characterized in these patients. METHODS: We studied the changes in LVEF among 549 patients with left ventricular systolic dysfunction (LVEF 10% in LVEF was considered clinically significant. RESULTS: Of the 549 patients (mean age 61.4±9.55 years, and 72 13.1% women), 145 (26.4%) had a >10% improvement in LVEF, 369 (67.2%) had no change and 35 (6.4%) had >10% worsening of LVEF following CABG. Patients with lower preoperative LVEF were more likely to experience an improvement after CABG (odds ratio 1.36; 95% CI 1.21-1.53; per 5% lower preoperative LVEF; p 10% improvement in LVEF after CABG was associated with a 57% lower risk of all-cause mortality (HR: 0.43, 95% CI: 0.26-0.71). CONCLUSIONS: Among patients with ischemic cardiomyopathy undergoing CABG, 26.4% had >10% improvement in LVEF. An improvement in LVEF was more likely in patients with lower preoperative LVEF and was associated with improved long-term survival.
Downey et al. (Thu,) conducted a observational in Ischemic cardiomyopathy with left ventricular systolic dysfunction (n=549). Coronary artery bypass graft surgery (CABG) was evaluated on All-cause mortality associated with >10% improvement in LVEF (HR 0.43, 95% CI 0.26-0.71). A >10% improvement in LVEF after CABG occurred in 26.4% of patients with ischemic cardiomyopathy and was associated with a 57% lower risk of all-cause mortality (HR 0.43; 95% CI 0.26-0.71).