What is the clinical evidence from this study?

Study design: Cohort. Population: Coronary artery bypass surgery (CABG) (n=33137). Intervention: Chronic obstructive pulmonary disease (COPD) vs. No comorbidities. Primary outcome: Long-term mortality (HR 1.8, 95% CI 1.6 to 2.1, p=<0.001).

What question did this study set out to answer?

To evaluate the impact of chronic obstructive pulmonary disease, both independently and alongside other comorbidities, on long-term survival following coronary artery bypass graft surgery.

July 4, 2006Circulation

Long-Term Survival of Patients With Chronic Obstructive Pulmonary Disease Undergoing Coronary Artery Bypass Surgery

Q: What are the key findings of this study?

Chronic obstructive pulmonary disease alone was associated with significantly worse long-term survival after CABG compared to no comorbidities (HR 1.8; 95% CI 1.6-2.1; P<0.001).

Q: What question did this study set out to answer?

To evaluate the impact of chronic obstructive pulmonary disease, both independently and alongside other comorbidities, on long-term survival following coronary artery bypass graft surgery.

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Key result

Chronic obstructive pulmonary disease alone was associated with significantly worse long-term survival after CABG compared to no comorbidities (HR 1.8; 95% CI 1.6-2.1; P<0.001).

Why the study?

Does the presence of COPD worsen long-term survival in patients undergoing isolated CABG?

Population

33,137 consecutive patients undergoing isolated coronary artery bypass surgery between 1992 and 2001 in…

Comparison

Presence of Chronic Obstructive Pulmonary… vs No comorbidities

Design

Cohort

Follow-up

131,434 person years of follow-up

Authors

BLBruce J. LeavittUniversity of Vermont Medical Center CRCathy S. RossInterventional / Structural Cardiology BSBrian C. SpenceNOAA National Marine Fisheries Service

Discussion

Member takes

Implication

COPD was associated with worse post-CABG survival; supports risk stratification but leaves open prospective trials on interventions.

Key Points

To evaluate the impact of chronic obstructive pulmonary disease, both independently and alongside other comorbidities, on long-term survival following coronary artery bypass graft surgery.
Prospective cohort study of 33,137 consecutive isolated coronary artery bypass surgery (CABG) patients treated between 1992 and 2001 in northern New England.
Patients were stratified into four comorbidity groups and tracked for 131,434 person-years through National Death Index linkage using Cox proportional hazards regression.
Mortality incidence rates per 100 person-years were 2.1 for no comorbidities, 4.0 for COPD alone, 5.5 for other comorbidities, and 9.4 for COPD plus other comorbidities (log-rank P < 0.001).
Compared with patients without comorbidities, adjusted long-term mortality was significantly higher for COPD alone (HR, 1.8; 95% CI, 1.6 to 2.1; P < 0.001) and other comorbidities alone (HR, 2.2; 95% CI, 2.1 to 2.4; P < 0.001).
Patients with both COPD and at least one other comorbidity exhibited the worst long-term survival relative to those without comorbidities (HR, 3.6; 95% CI, 3.3 to 3.9; P < 0.001).

Study Design

Type

Cohort (n=33,137)

Multicenter

Yes

Structured PICO

Does the presence of COPD worsen long-term survival in patients undergoing isolated CABG?

Population

33,137 consecutive patients undergoing isolated coronary artery bypass surgery, followed for long-term mortality.

Exposure

Presence of Chronic Obstructive Pulmonary Disease (COPD), with or without other comorbidities

Comparator

No comorbidities

Outcome

Long-term survival/mortalityhard clinical

Main Result

Hazard Ratio: 1.8 (95% CI 1.6–2.1)

Absolute Event Rate: 4% vs 2.1%

p-value: p=<0.001

COPD, especially when combined with other comorbidities, significantly reduces long-term survival in patients undergoing isolated CABG.

Cite This Study

Leavitt et al. (2006) conducted a cohort in Coronary artery bypass surgery (CABG) (n=33,137). Chronic obstructive pulmonary disease (COPD) vs. No comorbidities was evaluated on Long-term mortality (HR 1.8, 95% CI 1.6 to 2.1, p=<0.001). Chronic obstructive pulmonary disease alone was associated with significantly worse long-term survival after CABG compared to no comorbidities (HR 1.8; 95% CI 1.6-2.1; P<0.001).

synapsesocial.com/papers/6a99a55693fbc3428a54d521 https://doi.org/10.1161/circulationaha.105.000943

Topics

Heart failure HFrEF treatment

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Long-Term Survival of Patients With Chronic Obstructive Pulmonary Disease Undergoing Coronary Artery Bypass Surgery

Discussion

Member takes

Implication

Key Points

Study Design

Structured PICO

Main Result

Cite This Study

Topics

Long-Term Survival of Patients With Chronic Obstructive Pulmonary Disease Undergoing Coronary Artery Bypass Surgery

Discussion

Member takes

Implication

Key Points

Study Design

Structured PICO

Main Result

Cite This Study

Also Consider

Topics

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