title: Risk factors in coronary artery bypass surgery for patients 40 years of age and younger.
abstract: In patients undergoing coronary artery bypass surgery while under 40 years of age, prevalence of risk factors for coronary artery disease and prognostic factors for mortality were assessed. Ninety-four patients of such age were operated from 1979 until 1989. Eighty-two patients were male, 12 female. Fifty-eight patients (62%) had a history of myocardial infarction. Patients were predominantly in New York Heart Association class II or III (69%). In this study prevalence of risk factors for coronary artery disease was different compared to studies of patients undergoing coronary artery bypass grafting over 40 years of age. Smoking (83%), hypercholesterolaemia (79%), and positive family history for coronary heart disease (66%) were more prevalent in this study compared to other studies concerning patients older than 40 years of age whereas the occurrence of hypertension (25%) and diabetes (6%) was lower. Six patients (6%) had one-vessel disease, 15 patients (17%) had two-vessel disease and 73 patients (78%) showed triple-vessel disease. Similar studies of patients older than 40 years of age showed a lower prevalence of triple vessel disease than in this study. Hospital mortality amounted to 3 patients (3%). Five-year-survival rate was 93%. Multivariate survival analysis revealed left main stenosis and concomitant operations as significant prognostic factors of survival. Number of vessels diseased, sex, priority of operation, reoperation, or impaired left-ventricular function were not prognostic factors for mortality in this study.
authors.affiliation: Department of Thoracic Surgery, University Hospital Leiden, The Netherlands.
authors.forename: G C
authors.initials: GC
authors.lastname: Graziosi
authors.forename: D W
authors.initials: DW
authors.lastname: Wolterbeek
authors.forename: A P
authors.initials: AP
authors.lastname: Kappetein
authors.forename: H A
authors.initials: HA
authors.lastname: Huysmans
mesh_terms: D000328:Adult; D001026:Coronary Artery Bypass; D003327:Coronary Disease / Q000401:mortality*; D048909:Diabetes Complications; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006937:Hypercholesterolemia / Q000150:complications; D006973:Hypertension / Q000150:complications; D008297:Male; D011183:Postoperative Complications; D011379:Prognosis; D012307:Risk Factors; D012737:Sex Factors; D012907:Smoking / Q000009:adverse effects; D015996:Survival Rate