Serum triglycerides and HDL cholesterol--major predictors of long-term survival after coronary surgery.
The influence of pre-operative serum lipid levels on late clinical outcome after coronary artery bypass surgery was analysed in 83 patients undergoing coronary bypass surgery for stable angina pectoris. The mean follow-up period for surviving patients was 105 +/- 33 months (range 65-133). Twenty-two patients (27%) had died during follow-up, of whom 14 had sustained a fatal myocardial infarction and four had succumbed to other cardiovascular causes. Thirty-one patients sustained 35 cardiac events, defined as either fatal or non-fatal myocardial infarction, or reoperation, or PTCA during the follow-up period. With univariate analysis, pre-operative serum levels of total cholesterol and triglycerides were significantly related to cardiac events, P < 0.05 and P < 0.05, respectively. In a Cox proportional analysis, cardiac mortality and total mortality were related to serum triglycerides and HDL cholesterol (P < 0.05 and P < 0.01 respectively). Eighty-five percent of the patients with triglycerides < 2.0 mM.l-1 survived for 10 years, while only 48% of patients with triglycerides > 2.0 mM.l-1 remained alive for that period. Figures were similar for subjects with HDL cholesterol > 1.0 mM.l-1 or HDL cholesterol < 1.0 mM.l-1, at 89 and 38%, respectively. Only 28% of the patients with the combination triglycerides > 2.0 mM.l-1 and HDL cholesterol < 1.0 mM.l-1 were alive 10 years after surgery. These data suggest that dyslipidaemia, especially the combination of high serum triglycerides and low HDL cholesterol, is an important factor influencing long-term clinical outcome after coronary bypass surgery.
Lindén
T
T
Wallenberg Laboratory for Cardiovascular Research, Sahlgren's Hospital, University of Göteborg, Sweden.
Bondjers
G
G
Karlsson
T
T
Wiklund
O
O
D000787:Angina Pectoris / Q000097:blood / Q000401:mortality / Q000601:surgery*; D002784:Cholesterol / Q000097:blood; D008076:Cholesterol, HDL / Q000097:blood*; D001026:Coronary Artery Bypass / Q000401:mortality*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D016016:Proportional Hazards Models; D012307:Risk Factors; D016019:Survival Analysis; D013997:Time Factors; D016896:Treatment Outcome; D014280:Triglycerides / Q000097:blood*
D008076:Cholesterol, HDL; D014280:Triglycerides; D002784:Cholesterol