Effect of Peripheral Arterial Disease and Race on Survival After Coronary Artery Bypass Grafting

Background. Although peripheral arterial disease (PAD) is more prevalent among blacks, the effect of race on long-term survival after coronary artery bypass grafting (CABG) has not been examined in this population. Methods. A retrospective cohort study was conducted of CABG patients between 1992 and 2011. Long-term survival was compared in patients with and without PAD and stratified by race. Hazard ratios (HR) and 95% confidence intervals were computed using a Cox regression model. Results. Of 13,053 patients who underwent CABG, 1,501 (11%) had PAD, comprising 311 blacks and 1,190 whites. Median follow-up was 8.3 years. Long-term survival differed by race (no PAD: HR, 1.0; white PAD: adjusted HR, 1.5, 95% confidence interval, 1.4 to 1.6; black PAD: adjusted HR, 2.1, 95% confidence interval, 1.8 to 2.5; p < 0.0001 for trend). Conclusions. Risk of death after CABG was comparatively higher among black PAD patients. This finding provides useful outcome information for surgeons and their patients. (C) 2013 by The Society of Thoracic Surgeons