Impact of Complete Revascularization on Long-Term Outcomes After Coronary Artery Bypass Grafting in Patients With Left Ventricular Dysfunction

Impact of Complete Revascularization on Long-Term Outcomes After Coronary Artery Bypass Grafting in Patients With Left Ventricular Dysfunction
Circ J 2019; 83: 122–129

https://www.jstage.jst.go.jp/article/circj/83/1/83_CJ-18-0653/_pdf/-char/en

The long-term outcomes of complete revascularization (CR) in patients with left ventricular (LV) dysfunction undergoing coronary artery bypass grafting (CABG) remain unclear.

111 patients with LV ejection fraction ≤35% who underwent isolated first-time CABG:
 63 underwent CR
 48 underwent incomplete revascularization (IR).

At a median follow-up of 10.1 years, the rates of death from any cause, cardiac death, and MACCE were significantly greater in the IR group.

After adjusting for propensity score,
NO! significant difference was found between the CR and IR groups regarding death from any cause (hazard ratio [HR], 1.45; 95% CI: 0.75–2.81; P=0.271) and cardiac death (HR, 1.45; 95% CI: 0.68–3.10; P=0.337). In contrast, IR increased the risk of MACCE (HR, 1.92; 95% CI: 1.08–3.41; P=0.027), which was principally attributed to an increased risk of repeat revascularization (HR, 3.92; 95% CI: 1.34–11.44; P=0.013).

Although IR was not significantly associated with an increased risk of long-term mortality in patients with LV dysfunction who underwent CABG, CR might reduce the risks of repeat revascularization and subsequent MACCE.


Does the Cardiac Surgeon Accept Coronary Artery Bypass  Grafting With Incomplete Revascularization for Patients  With Low Ventricular Function and Complex  Multivessel Coronary Disease?