Susanne Nielsen1, Lena Björck2, Anders Jeppsson3, K W Giang4, Kristin Falk5, Sylvia Määttä5, Tatiana Zverkova Sandström4, Annika Rosengren4. 1. Department of Molecular and Clinical Medicine, Sahlgrenska Academy, Gothenburg University, Sweden. Electronic address: susanne.nielsen@gu.se. 2. Department of Molecular and Clinical Medicine, Sahlgrenska Academy, Gothenburg University, Sweden; Institute of Health and Care Sciences, Sahlgrenska Academy, Gothenburg University, Sweden. 3. Department of Molecular and Clinical Medicine, Sahlgrenska Academy, Gothenburg University, Sweden; Department of Cardiothoracic Surgery, Sahlgrenska University Hospital, Gothenburg, Sweden. 4. Department of Molecular and Clinical Medicine, Sahlgrenska Academy, Gothenburg University, Sweden. 5. Institute of Health and Care Sciences, Sahlgrenska Academy, Gothenburg University, Sweden.
Abstract
BACKGROUND: Updated knowledge about survival after coronary artery bypass graft (CABG) surgery is needed. We examined 20-year trends in 4-year survival after a first isolated CABG procedure, compared with that of the general population. METHODS: We identified 94,328 patients surviving 30days after a first isolated CABG 1987-2006 from the Swedish Inpatient Register. RESULTS: Crude annual mortality rates remained stable at approximately 1% in patients aged 18-54years and at approximately 2% in those aged ≥55years. After adjustment for comorbidities, 4-year survival in men aged 18-54 and ≥55years improved by 37% (HR: 0.63, 95% CI, 0.46-0.88) and 31% (HR: 0.69, 95% CI, 0.63-0.76), respectively, (1987-1991 vs. 2002-2006). The corresponding estimate for women aged ≥55years was 38% (HR: 0.62, 95% CI, 0.52-0.75), with no significant change in survival in women aged <55years (HR: 1.02, 95% CI, 0.52-2.03). Men and women aged <55years had higher mortality than the general population, with standardized mortality ratios (SMR) of 1.76 (95% CI, 1.35-2.22) in men and 4.49 (95% CI, 2.74-6.68) in women during the last period (2002-2006). In contrast, patients aged ≥55years had better survival with a SMR of 0.74 (95% CI, 0.70-0.78) in men and 0.82 (95% CI, 0.74-0.91) in women during 2002-2006. CONCLUSION: During 1987-2006, there was a significant improvement in survival after CABG for all categories, except in women aged <55years. Men and women aged ≥55years who survived the first 30days after CABG had a lower mortality risk than the general population.
BACKGROUND: Updated knowledge about survival after coronary artery bypass graft (CABG) surgery is needed. We examined 20-year trends in 4-year survival after a first isolated CABG procedure, compared with that of the general population. METHODS: We identified 94,328 patients surviving 30days after a first isolated CABG 1987-2006 from the Swedish Inpatient Register. RESULTS: Crude annual mortality rates remained stable at approximately 1% in patients aged 18-54years and at approximately 2% in those aged ≥55years. After adjustment for comorbidities, 4-year survival in men aged 18-54 and ≥55years improved by 37% (HR: 0.63, 95% CI, 0.46-0.88) and 31% (HR: 0.69, 95% CI, 0.63-0.76), respectively, (1987-1991 vs. 2002-2006). The corresponding estimate for women aged ≥55years was 38% (HR: 0.62, 95% CI, 0.52-0.75), with no significant change in survival in women aged <55years (HR: 1.02, 95% CI, 0.52-2.03). Men and women aged <55years had higher mortality than the general population, with standardized mortality ratios (SMR) of 1.76 (95% CI, 1.35-2.22) in men and 4.49 (95% CI, 2.74-6.68) in women during the last period (2002-2006). In contrast, patients aged ≥55years had better survival with a SMR of 0.74 (95% CI, 0.70-0.78) in men and 0.82 (95% CI, 0.74-0.91) in women during 2002-2006. CONCLUSION: During 1987-2006, there was a significant improvement in survival after CABG for all categories, except in women aged <55years. Men and women aged ≥55years who survived the first 30days after CABG had a lower mortality risk than the general population.
Authors: Ashraf Hamarneh; Andrew Fu Wah Ho; Derek M Yellon; Derek J Hausenloy; Heerajnarain Bulluck; Vivek Sivaraman; Federico Ricciardi; Jennifer Nicholas; Hilary Shanahan; Elizabeth A Hardman; Peter Wicks; Manish Ramlall; Robin Chung; John McGowan; Roger Cordery; David Lawrence; Tim Clayton; Bonnie Kyle; Maria Xenou; Cono Ariti Journal: Basic Res Cardiol Date: 2022-06-21 Impact factor: 12.416
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