Τίτλος:
Preoperative prediction of long-term survival after coronary artery
bypass grafting in patients with low left ventricular ejection fraction
Γλώσσες Τεκμηρίου:
Αγγλικά
Περίληψη:
Objective: We aimed to develop multivariable models of preoperative risk
factors that predict long-term survival after coronary artery bypass
grafting in patients with b ejection fraction 25% or less.
Methods: We retrospectively evaluated 544 consecutive patients with
ejection fraction 25% or less who underwent coronary artery bypass
grafting from 1992 to 2002 at a single institution. Long-term survival
data (mean follow-up 4.1 years) were obtained from the National Death
Index. Multivariable Cox regression analysis was performed to construct
a predictive score for long-term mortality. A split-sample approach was
also used building a model on a training group (n = 360); this model was
then tested on a separate validation group (n = 184).
Results: From the entire database, the predictive score was calculated
according to the following equation: 0.430 (if past congestive heart
failure) + 0.049 (age in years) + 0.507(if peripheral vascular disease)
+ 0.580 (if emergency operation) + 0.366 (if chronic obstructive
pulmonary disease). The 5-year survivals of the predictive score
quartiles were 82.3%, 78.2%, 65.5%, and 45.5% (P < .0001). The model
based on the training group had four independent predictors for
long-term mortality (the same as the listed equation except for past
congestive heart failure). The 5-year survival rates of the quartiles
were 90.1%, 75.4%, 64.3%, and 49.2% in the training group (P <
.0001) and 77.4%, 71.2%, 65.8%, and 45.5% in the validation group (P
= .0001).
Conclusion: Coronary artery bypass grafting in patients with severe
ischemic cardiomyopathy achieves satisfactory midterm and long-term
survival in selected patients. This new score, which is based on
long-term data from a large number of patients, may aid clinicians in
selecting therapeutic interventions for patients with ischemic
cardiornyopathy.
Συγγραφείς:
DeRose, JJ
Toumpoulis, IK
Balaram, SK
Ioannidis, JP and
Belsley, S
Ashton, RC
Swistel, DG
Anagnostopoulos, CE
Περιοδικό:
The Internet Journal of Thoracic and Cardiovascular Surgery
DOI:
10.1016/j.jtcvs.2004.05.022
