Key Points
- To evaluate 30-day mortality, long-term survival, and recurrent cardiac events following coronary artery bypass graft surgery in a population-based cohort.
- Follow-up study analyzing 8,910 patients who underwent an isolated first coronary artery bypass graft (CABG) between 1980 and 1993 in Western Australia.
- Tracked outcomes through mid-1999 using prospective cardiothoracic surgical database records linked to hospital readmissions and death registries.
- Evaluated primary endpoints of 30-day survival, long-term survival, and readmission for recurrent cardiac events (myocardial infarction, unstable angina, angioplasty, or repeat CABG).
- A total of 3,072 deaths occurred by mid-1999, with 30-day and long-term survival significantly higher during the first five years (1980–1984) than in the subsequent decade as patient age, proportion of females, and graft counts increased.
- Increased 30-day mortality was associated with urgent procedures (odds ratio 3.3), female sex (odds ratio 1.5), and older age (9% increased risk per year).
- Poorer long-term survival was associated with advancing age (7% increased risk per year) and recent myocardial infarction (odds ratio 1.16), whereas internal mammary artery grafts were associated with superior survival compared to saphenous vein grafts alone.
Structured PICO
PPopulation8,910 patients undergoing isolated first coronary artery bypass graft (CABG) between 1980 and 1993 in Western Australia.
IInterventionIsolated first coronary artery bypass graft (CABG)
OOutcome30 day and long term survival, readmission for cardiac event (acute myocardial infarction, unstable angina, percutaneous transluminal coronary angioplasty or reoperative CABG)hard clinical
In a population-based cohort, crude 30-day mortality after CABG worsened over time due to the inclusion of higher-risk patients, while older age, recent MI, and saphenous vein grafts only were associated with poorer long-term survival.
Limitations
- Selection bias in favour of younger male patients for internal mammary artery grafts