Risk factors in coronary artery bypass surgery for patients 40 years of age and younger.
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.
Graziosi
G C
GC
Department of Thoracic Surgery, University Hospital Leiden, The Netherlands.
Wolterbeek
D W
DW
Kappetein
A P
AP
Huysmans
H A
HA
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