4.7 Article

Clinical outcomes and quality of life after contemporary isolated coronary bypass grafting: a prospective cohort study

Journal

INTERNATIONAL JOURNAL OF SURGERY
Volume 109, Issue 4, Pages 707-715

Publisher

LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.1097/JS9.0000000000000259

Keywords

clinical outcomes; coronary artery bypass grafting; endothelial damage inhibitor; quality of life; saphenous vein graft

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The objective of this study was to evaluate the clinical outcomes and quality of life of patients undergoing coronary artery bypass grafting (CABG) using an endothelial damage inhibitor (DuraGraft). The results showed that over time, the clinical event rate of patients decreased and their quality of life improved.
Objectives: The objective of the European Multicenter Registry to Assess Outcomes in coronary artery bypass grafting (CABG) patients (DuraGraft Registry) was to determine clinical outcomes and quality of life (QoL) after contemporary CABG that included isolated CABG and combined CABG/valve procedures, using an endothelial damage inhibitor (DuraGraft) intraoperatively for conduit preservation. Here, we report outcomes in the patient cohort undergoing isolated CABG. Methods: The primary outcome was the composite of all-cause death, myocardial infarction (MI), or repeat revascularization (RR) [major adverse cardiac events (MACE)] at 1 year. Secondary outcomes included the composite of all-cause death, MI, RR, or stroke [major adverse cardiac and cerebrovascular events (MACCE)], and QoL. QoL was assessed with the EuroQol-5 Dimension questionnaire. Independent risk factors for MACE at 1 year were determined using Cox regression analysis. Results: A total of 2532 patients (mean age, 67.4 +/- 9.2 years; 82.5% male) underwent isolated CABG. The median EuroScore II was 1.4 [interquartile range (IQR), 0.9-2.3]. MACE and MACCE rates at 1 year were 6.6% and 7.8%, respectively. The rates of allcause death, MI, RR, and stroke were 4.4, 2.0, 2.2, and 1.9%, respectively. The 30-day mortality rate was 2.3%. Age, extracardiac arteriopathy, left ventricular ejection fraction less than 50%, critical operative state, and left main disease were independent risk factors for MACE. QoL index values improved from 0.84 [IQR, 0.72-0.92] at baseline to 0.92 [IQR, 0.82-1.00] at 1 year (P < 0.0001). Conclusion: Contemporary European patients undergoing isolated CABG have a low 1-year clinical event rate and an improved QoL.

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