Key result
Age over 70 years did not significantly increase midterm mortality compared to age 70 or younger in patients with moderate IMR undergoing CABG plus mitral valve repair (HR 1.143; 95% CI 0.761-1.943).
Why the study?
Few reports have focused on clinical outcomes of patients over 70 years of age with moderate chronic ischemic mitral regurgitation undergoing mitral valve repair at the time of CABG.
Does age over 70 years worsen in-hospital and midterm clinical outcomes in patients with moderate ischemic mitral regurgitation undergoing CABG plus mitral valve repair compared to younger patients?
Cohort (n=324)
No
Does age over 70 years worsen in-hospital and midterm clinical outcomes in patients with moderate ischemic mitral regurgitation undergoing CABG plus mitral valve repair compared to younger patients?
Patients over 70 years of age with moderate chronic ischemic mitral regurgitation undergoing combined CABG and mitral valve repair have comparable in-hospital and midterm clinical outcomes to younger patients.
May support individualized mitral repair decisions in elderly CABG patients; hypothesis-generating and requires randomized confirmation.
BACKGROUND: Elderly patients, compared with the young, have a higher burden of surgical risk factors with reduced functional capacity and increased comorbidities conditions, and may have worse clinical outcomes. So far, few reports have focused on clinical outcomes of patients over 70 years of age with moderate chronic ischemic mitral regurgitation (IMR) undergoing mitral valve repair at the time of coronary artery bypass grafting (CABG). This single-center study of propensity-matched data attempts to answer a question: compared with patients with age of 70 or less, whether patients over 70 years of age with moderate IMR undergoing CABG plus mitral valve repair receive poor outcomes. METHODS: All eligible patients were included in this study and were entered into either an elderly group (n=142) or a control group (n=182) according to patients' age. In-hospital outcomes (consisting of surgical mortality and major postoperative morbidity) and midterm clinical outcomes (including all-cause mortality and recurrent mitral regurgitation) were compared after propensity score matching (1:1). RESULTS: 3.9%, P=0.754) and major postoperative morbidity. A total of 184 patients (91 in the elderly group and 93 in the control group) received regular follow-up visit with the median duration of 38 months [interquartile range (IQR), 27-56 months]. There were not any significant differences between the two matched groups regarding overall survival and recurrent IMR-free survival (stratified log-rank P=0.185 and stratified log-rank P=0.453, respectively). The elderly group as compared to the control group did not affect midterm mortality via cox proportional hazard regression (propensity score adjusted hazard ratio, 1.143; 95% confidence interval, 0.761-1.943; P=0.285). CONCLUSIONS: Patients over 70 years of age with moderate chronic IMR undergoing combined CABG and mitral valve repair may receive favorable in-hospital and midterm clinical outcomes.
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Ji et al. (2019) conducted a cohort in Moderate chronic ischemic mitral regurgitation (n=324). Age > 70 years vs. Age ≤ 70 years was evaluated on Midterm mortality (HR 1.143, 95% CI 0.761-1.943, p=0.285). Age over 70 years did not significantly increase midterm mortality compared to age 70 or younger in patients with moderate IMR undergoing CABG plus mitral valve repair (HR 1.143; 95% CI 0.761-1.943).
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