High mortality after coronary bypass surgery in patients with high-grade left main coronary artery stenosis.
OBJECTIVE
To determine mortality after coronary artery bypass grafting (CABG) in relation to degree of left main coronary artery (LMCA) obstruction.


METHODS
All patients without LMCA stenosis (n=3370), with low-grade stenosis (n = 261), high-grade stenosis (n = 224) or total occlusion of the LMCA (n = 15) were followed for ten years after CABG performed during 1970-1989.


RESULTS
Early mortality was 1.9% and 2.3%, respectively, if there was no or a low-grade LMCA stenosis vs. 6.3% if the stenosis was high-grade. Ten-year survival was 76% if no LMCA obstruction, 74% if low-grade stenosis and 64% if the stenosis was high-grade. Risk of early death (odds ratio 2.6, 95% CI 1.4-4.8) and mortality at ten years (relative risk 1.5, 95% CI 1.1-2.0) was higher in patients with high-grade stenosis than in those without LMCA stenosis. There was no increased long-term mortality in patients with low-grade stenosis or among the few patients with occlusion of the LMCA.


CONCLUSIONS
High-grade LMCA stenosis was associated with a three-fold increased risk of early and fifty percent higher risk of late death than in patients without LMCA stenosis.
Jönsson
Anders
A
Department of Thoracic Surgery, Karolinska Institutet, Stockholm, Sweden.
Hammar
Niklas
N
Liska
Jan
J
Nordqvist
Tobias
T
Ivert
Torbjörn
T
D000368:Aged; D001026:Coronary Artery Bypass; D023921:Coronary Stenosis / Q000401:mortality* / Q000473:pathology / Q000601:surgery; D003331:Coronary Vessels / Q000473:pathology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D013997:Time Factors