Outcome of patients with low ejection fraction undergoing coronary artery bypass grafting: Renal function and mortality after 3.8 years

Graham S. Hillis, Kenton J. Zehr, Amy W. Williams, Hartzell V Schaff, Thomas A. Orzulak, Richard C. Daly, Charles J. Mullany, Richard J. Rodeheffer, Jae Kuen Oh

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Abstract

BACKGROUND - There are few data regarding medium-term outcome of coronary artery bypass grafting (CABG) in patients with severe left ventricular (LV) systolic dysfunction, particularly in the modern era, and even less assessing preoperative factors that might identify patients at highest risk. METHODS AND RESULTS - Three hundred seventy-nine consecutive patients with LV ejection fraction ≤35%, who underwent isolated first CABG between 1995 and 1999 were studied. Potential preoperative and perioperative predictors of outcome were recorded and patients followed-up for a median of 3.8 years. The primary study end-point was all-cause mortality. The 30-day, 1-year, and 3-year survival rates were 94.5%, 88%, and 81%, respectively. The independent predictors of mortality were preoperative estimated glomerular filtration rate (hazard ratio [HR], 0.98; 95% confidence interval [CI], 0.97 to 0.99 per mL/min/1.73m; P<0.001) and age (HR, 1.03; 95% CI, 1.01 to 1.06 per year; P=0.005). CONCLUSIONS - Patients with significant LV systolic dysfunction undergoing isolated CABG using contemporary techniques have a good medium-term survival. Renal dysfunction is the strongest independent predictor of mortality.

Original languageEnglish (US)
JournalCirculation
Volume114
Issue numberSUPPL. 1
DOIs
StatePublished - Jul 2006

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Coronary Artery Bypass
Kidney
Mortality
Left Ventricular Dysfunction
Confidence Intervals
Glomerular Filtration Rate
Stroke Volume
Survival Rate
Survival

Keywords

  • Coronary disease
  • Kidney
  • Surgery
  • Survival

ASJC Scopus subject areas

  • Physiology
  • Cardiology and Cardiovascular Medicine

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Outcome of patients with low ejection fraction undergoing coronary artery bypass grafting : Renal function and mortality after 3.8 years. / Hillis, Graham S.; Zehr, Kenton J.; Williams, Amy W.; Schaff, Hartzell V; Orzulak, Thomas A.; Daly, Richard C.; Mullany, Charles J.; Rodeheffer, Richard J.; Oh, Jae Kuen.

In: Circulation, Vol. 114, No. SUPPL. 1, 07.2006.

Research output: Contribution to journalArticle

Hillis, Graham S. ; Zehr, Kenton J. ; Williams, Amy W. ; Schaff, Hartzell V ; Orzulak, Thomas A. ; Daly, Richard C. ; Mullany, Charles J. ; Rodeheffer, Richard J. ; Oh, Jae Kuen. / Outcome of patients with low ejection fraction undergoing coronary artery bypass grafting : Renal function and mortality after 3.8 years. In: Circulation. 2006 ; Vol. 114, No. SUPPL. 1.
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AU - Schaff, Hartzell V

AU - Orzulak, Thomas A.

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AU - Mullany, Charles J.

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