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Early and long term coronary artery bypass grafting outcomes in patients under 45 years of age.
MedLine Citation:
PMID:  23348531     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
BACKGROUND: In Poland, mortality and morbidity rates due to ischaemic heart disease (IHD) remain high and concern the whole population. An interesting issue is rapid development of IHD in some younger subjects and uncertain treatment outcomes in this patient subset. Premature cessation of professional activity, along with worsening of quality of life due to IHD in the population under 45 years of age is a huge medical, economic, and social problem. Only few studies evaluated early and long-term outcomes of coronary artery bypass grafting (CABG) used for the treatment of IHD in young patients, especially in premenopausal women.
AIM: The purpose of the study was to analyse early and long-term outcomes of CABG in patients under 45 years of age.
METHODS: We studied 125 patients under 45 years of age who underwent a CABG procedure. The study group included 65 women aged 27-45 (mean 41.5 ± 3.5) years operated upon in 1990-1999, and 60 men aged 33-45 (mean 41 ± 3.2) years operated upon in 1993. We evaluated early postoperative outcomes. The two genders were compared in regard to survival free from death, recurrent angina, and repeated myocardial during long-term follow-up. We also evaluated other variables such as education level, professional activity, and exposure to IHD risk factors before and after the operation.
RESULTS: Seven women and two men died in hospital after CABG (p = 0.2). Analysis of major postoperative outcomes like myocardial infarction, low cardiac output syndrome requiring support with intra-aortic balloon pump (IABP), a lower limb amputation following the use of IABP, ischaemic stroke, and respiratory failure showed that these complications were significantly more frequent in women than in men (p < 0.01). Differences between the two groups regarding other adverse outcomes including atrial fibrillation, sternal instability, haemothorax, and pneumothorax were not significant. Analysis of long-term survival curves did not show any significant differences between men and women in regard to rates of death, recurrent angina, and the need for repeated myocardial revascularisation (p = 0.64, p = 0.93, and p = 0.13, respectively).
CONCLUSIONS: Young women who underwent CABG were burdened with higher early postoperative morbidity and mortality than young men. However, long-term outcomes (mortality, recurrent angina, and repeated myocardial revascularisation rates) did not differ significantly between the two groups. Regardless of gender, repeated myocardial revascularisation rate was significantly higher among those patients who continued to smoke after the surgery (p < 0.01).
Authors:
Radosław Zwoliński; Sławomir Jander; Stanisław Ostrowski; Karol Bartczak; Anna Adamek Kośmider; Andrzej Banyś; Ryszard Jaszewski
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Kardiologia polska     Volume:  71     ISSN:  0022-9032     ISO Abbreviation:  Kardiol Pol     Publication Date:  2013  
Date Detail:
Created Date:  2013-01-25     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0376352     Medline TA:  Kardiol Pol     Country:  Poland    
Other Details:
Languages:  eng     Pagination:  32-9     Citation Subset:  IM    
Affiliation:
Department of Cardiac Surgery, Medical University of Lodz, Poland. radekzwolinski@poczta.onet.pl.
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