Key result
Left main coronary artery obstruction was associated with increased early mortality after bypass surgery compared to patients without obstruction (4.7% vs 1.9%; RR 1.9, 95% CI 1.1-3.5).
Why the study?
Does left main coronary artery (LMCA) obstruction increase early and long-term mortality after coronary artery bypass surgery compared to patients without LMCA obstruction?
Cohort (n=384)
Does left main coronary artery (LMCA) obstruction increase early and long-term mortality after coronary artery bypass surgery compared to patients without LMCA obstruction?
Left main coronary artery obstruction is associated with an increased risk of both early and long-term mortality following coronary artery bypass surgery.
Answers are grounded in this paper and cite their sources.
LMCA obstruction may raise early post-CABG mortality; leaves open confirmation in prospective data and impact on risk models.
Angiographies of 384 patients who had coronary artery bypass surgery because of left main coronary artery (LMCA) obstruction during 1970–1989 were reviewed by analysing the pathology, feasibility of surgical angioplasty and survival. Complete LMCA occlusion was found in 2%, proximal ostial stenosis in 9%, mid-shaft stenosis in 24%, circular stenosis in 25% and distal bifurcation stenosis in 40% of the patients. Patients with an ostial stenosis were younger, more often women with less coronary artery disease and less calcified obstructions. Surgical angioplasty could have been an option in 22% of the patients. Early mortality was higher in patients with (4.7%) than in those without (1.9%) LMCA obstruction. The relative risk (RR) of early death was 1.9 (95% CL 1.1–3.5) after adjustment for patient characteristics. Similarly, the RR at 10 years was 1.3 (95% CL 1.0–1.6). LMCA obstruction was associated with an early and long-term increased mortality after surgery compared to patients without LMCA obstruction.
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Jönsson et al. (2003) conducted a cohort in Left main coronary artery (LMCA) obstruction (n=384). Left main coronary artery (LMCA) obstruction vs. Patients without LMCA obstruction was evaluated on Early mortality (RR 1.9, 95% CI 1.1-3.5). Left main coronary artery obstruction was associated with increased early mortality after bypass surgery compared to patients without obstruction (4.7% vs 1.9%; RR 1.9, 95% CI 1.1-3.5).
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