Does angiographic severity of coronary artery disease predict postoperative outcome after coronary artery bypass surgery?
OBJECTIVE
It is not clear whether the severity of coronary artery disease as assessed on angiography has an impact on the postoperative outcome after coronary artery bypass surgery (CABG).


METHODS
The angiographic status of 15 coronary arteries/segments of 2,233 patients who underwent isolated on-pump CABG was graded according to the following criteria: 1 = no stenosis; 2 = stenosis <50%; 3 = stenosis of 50-69%; 4 = stenosis of 70-89%; 5 = stenosis of 90-99%; 6 = vessel occlusion; and 7 = vessel is not visualized.


RESULTS
Thirty-seven patients (1.7%) died during the in-hospital stay and 108 (4.8%) developed postoperatively low cardiac output syndrome. Multivariate analysis showed that along with other risk factors the overall coronary angiographic score was predictive of postoperative death (p = 0.03; OR: 1.027, 95% CI: 1.003-1.052) and of low cardiac output syndrome (p = 0.04; OR: 1.172, 95% CI: 1.010-1.218). The status of the proximal segment of the left circumflex coronary artery, the diagonal arteries and the left obtuse marginal arteries was most closely associated with adverse postoperative outcome.


CONCLUSIONS
The angiographic status of coronary arteries has an impact on the immediate outcome after CABG.
Biancari
Fausto
F
Division of Cardiothoracic Surgery, Department of Surgery, University of Oulu and Oulu University Hospital, Oulu, Finland. faustobiancari@yahoo.it
Lahtinen
Jarmo
J
Salmela
Esa
E
Niemelä
Matti
M
Pokela
Risto
R
Rainio
Pekka
P
Lepojärvi
Martti
M
Satta
Jari
J
Juvonen
Tatu
T
D000368:Aged; D002303:Cardiac Output, Low / Q000209:etiology*; D017023:Coronary Angiography; D001026:Coronary Artery Bypass; D003327:Coronary Disease / Q000000981:diagnostic imaging* / Q000601:surgery; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011183:Postoperative Complications / Q000209:etiology*; D011237:Predictive Value of Tests; D016896:Treatment Outcome