Key result
Malignancy was associated with significantly higher long-term all-cause mortality following coronary artery bypass grafting compared to patients without malignancy (55% vs 10%, p<0.0001), primarily driven by cancer progression rather than cardiac events.
Why the study?
In patients with severe CAD, tumor surgery risk under general anesthesia is high, and whether coronary revascularization should be prioritized remains debatable given tumor prognosis.
Does coronary artery bypass graft surgery (CABG) have similar outcomes in patients with malignancy compared to those without malignancy?
Cohort (n=276)
No
Does coronary artery bypass graft surgery (CABG) have similar outcomes in patients with malignancy compared to those without malignancy?
CABG can be safely performed in patients with malignancy, preventing postoperative cardiac events and allowing for subsequent cancer treatment, with cardiac outcomes comparable to patients without malignancy.
Comparable short-term CABG mortality in malignancy; hypothesis-generating and should not yet change practice.
Objective: In patients with severe coronary artery disease (CAD), the risk of tumor surgery under general anesthesia is high, and whether coronary revascularization should be prioritized remains debatable, considering tumor prognosis. We aimed to analyze surgical outcomes for severe CAD with malignancy. Materials and Methods: We analyzed 20 patients with malignant tumors and 256 who underwent coronary artery bypass graft surgery (CABG) at our hospital to investigate early and long-term outcomes. We also conducted propensity score analysis. Results: No significant differences were observed in preoperative background. Patients with malignancy had significantly fewer lesions and bypass grafts. There was no significance in postoperative complications or cardiac events. After propensity score matching, results were similar. Treatment for malignancy was performed safely post-CABG. However, two patients could not undergo scheduled treatment because of change in their clinical condition after CABG. Conclusion: CABG in patients with malignancy was safely performed and prevented postoperative cardiac events. Because postoperative status can be changeable, cancer team management should be considered for all CABG cases with malignancy.
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Sugiyama et al. (2025) conducted a cohort in Severe coronary artery disease requiring CABG (n=276). Malignancy vs. No malignancy was evaluated on All-cause mortality (p=<0.0001). Malignancy was associated with significantly higher long-term all-cause mortality following coronary artery bypass grafting compared to patients without malignancy (55% vs 10%, p<0.0001), primarily driven by cancer progression rather than cardiac events.
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