What is the clinical evidence from this study?

Study design: Observational. Population: Coronary artery disease with severe left ventricular dysfunction (n=97). Intervention: Elective coronary artery bypass graft (CABG) vs. Preoperative baseline. Primary outcome: Left ventricular ejection fraction (LVEF) (p=<0.05).

What question did this study set out to answer?

To evaluate early and midterm clinical outcomes of elective coronary artery bypass grafting in patients with severe left ventricular dysfunction.

July 1, 2004Biomedical PapersOpen Access

Myocardial Revascularisation in Patients With Severe Left Ventricular Dysfunction. Early and Midterm Results

Q: What are the key findings of this study?

Elective coronary artery bypass grafting in patients with severe left ventricular dysfunction significantly improved mean left ventricular ejection fraction from 23.1% to 36.0%.

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

To evaluate early and midterm clinical outcomes of elective coronary artery bypass grafting in patients with severe left ventricular dysfunction.

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Key result

Elective coronary artery bypass grafting in patients with severe left ventricular dysfunction significantly improved mean left ventricular ejection fraction from 23.1% to 36.0%.

Why the study?

Does elective coronary artery bypass grafting improve survival and symptoms in patients with coronary artery disease and severe left ventricular dysfunction (LVEF ≤ 25%)?

Key Points

To evaluate early and midterm clinical outcomes of elective coronary artery bypass grafting in patients with severe left ventricular dysfunction.
Retrospective review of 97 consecutive patients with coronary artery disease and left ventricular ejection fraction (LVEF) ≤ 25% who underwent elective bypass surgery between September 1998 and December 2001.
Preoperative assessment included cardiac index, echocardiography, planimetry, and left ventricular end-diastolic dimensions, followed by postoperative echocardiographic evaluation.
Early 30-day postoperative mortality was 4.1%, and postoperative complications occurred in 26% of patients (n=25).
Two-year overall survival reached 95.7%, with advanced symptoms (CCS or NYHA class III–IV) dropping to 17.5% of patients (n=17).
Mean left ventricular ejection fraction improved significantly from 23.1% preoperatively to 36.0% postoperatively (p < 0.05).

Study Design

Type

Observational (n=97)

Multicenter

Structured PICO

Does elective coronary artery bypass grafting improve survival and symptoms in patients with coronary artery disease and severe left ventricular dysfunction (LVEF ≤ 25%)?

Population

97 patients (mean age 66 years, 15.5% female) with coronary artery disease and severe left ventricular dysfunction (LVEF ≤ 25%) undergoing elective CABG, followed for a mean of 13 months.

Intervention

Elective coronary artery bypass graft (CABG) procedure

Outcome

Early postoperative (30 days) mortality and midterm (2 years) survivalhard clinical

Main Result

Absolute Event Rate: 36% vs 23.1%

p-value: p=<0.05

Elective CABG in patients with severe left ventricular dysfunction (LVEF ≤ 25%) can be performed with low operative mortality and is associated with significant midterm survival and LVEF improvement.

Limitations

Preoperative stress-thallium scintigraphy data were obtained in only 41.2% of patients.
Stress dobutamine echocardiography was assessed in only 46% of patients.
No control angiograms and ventriculography were performed during follow up.
Retrospective design without a medical therapy control group.

Discussion

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Implication

Elective CABG may improve LVEF in severe LV dysfunction; leaves open survival and symptom benefits without randomized confirmation.

Cite This Study

Škorpil et al. (2004) conducted an observational in Coronary artery disease with severe left ventricular dysfunction (n=97). Elective coronary artery bypass graft (CABG) vs. Preoperative baseline was evaluated on Left ventricular ejection fraction (LVEF) (p=<0.05). Elective coronary artery bypass grafting in patients with severe left ventricular dysfunction significantly improved mean left ventricular ejection fraction from 23.1% to 36.0%.

synapsesocial.com/papers/6a9e5bfce056b05edee98932 https://doi.org/10.5507/bp.2004.009

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Myocardial Revascularisation in Patients With Severe Left Ventricular Dysfunction. Early and Midterm Results

Key Points

Study Design

Structured PICO

Main Result

Limitations

Discussion

Implication

Cite This Study

Myocardial Revascularisation in Patients With Severe Left Ventricular Dysfunction. Early and Midterm Results

Key Points

Study Design

Structured PICO

Main Result

Limitations

Discussion

Implication

Cite This Study

Also Consider

Also Consider