Chronic obstructive pulmonary disease significantly decreased long-term survival after coronary artery bypass grafting (adjusted HR 1.9), with no survival disadvantage observed for black patients compared to white patients.
Cohort (n=4,801)
No
Does the presence of COPD affect long-term survival after CABG differently in black versus white patients?
COPD is a significant predictor of decreased long-term survival after CABG, but contrary to general population trends, black patients with COPD did not exhibit a worse survival disadvantage compared to white patients with COPD.
Hazard Ratio: 1.9 (95% CI 1.6–2.2)
Absolute Event Rate: 73% vs 87%
p-value: p=<0.0001
BACKGROUND: Chronic obstructive pulmonary disease (COPD) is a known predictor of decreased long-term survival after coronary artery bypass grafting (CABG). Differences in survival by race have not been examined. METHODS: A retrospective cohort study was conducted of CABG patients between 2002 and 2011. Long-term survival was compared in patients with and without COPD and stratified by race. Hazard ratios (HR) and 95% confidence intervals (CI) were computed using a Cox regression model. RESULTS: = 4,801).The median follow-up for study participants was 4.4 years. COPD was observed to be a statistically significant predictor of decreased survival independent of race following CABG (no COPD: HR = 1.0; white COPD: adjusted HR = 1.9, 95% CI = 1.7-2.3; black COPD: adjusted HR = 1.6, 95% CI = 1.1-2.2). CONCLUSION: Contrary to the expected increased risk of mortality among black COPD patients in the general population, a similar survival disadvantage was not observed in our CABG population.
Efird et al. (2013) conducted a cohort in Coronary Artery Disease requiring CABG (n=4,801). Chronic obstructive pulmonary disease (COPD) vs. No COPD was evaluated on Long-term mortality (HR 1.9, 95% CI 1.6-2.2, p=<0.0001). Chronic obstructive pulmonary disease significantly decreased long-term survival after coronary artery bypass grafting (adjusted HR 1.9), with no survival disadvantage observed for black patients compared to white patients.