title: Comparison of two-year outcomes in patients undergoing isolated coronary artery bypass grafting with and without peripheral artery disease.
abstract: We aimed to evaluate the long-term clinical outcomes among patients with peripheral arterial disease (PAD) after coronary artery bypass grafting. We studied 589 consecutive patients who had undergone isolated coronary artery bypass grafting from January 2003 to June 2005 at our university hospital. The effect of PAD was assessed by comparing the 2-year follow-up data from 2 groups of patients: 243 patients with and 346 without PAD. A large systematic atherosclerosis screening was performed, including cerebrovascular disease, lower extremity artery disease, and abdominal aorta disease and its branches. PAD was defined as a history of treated atherosclerotic disease and significant atherosclerotic stenosis on screening. Patients with PAD were significantly older (70 +/- 9 vs 64 +/- 11 years, p <0.001) and were more often men (p = 0.04) than those without PAD. They had a greater incidence of hypertension (p = 0.002), chronic renal dysfunction (p <0.01), chronic pulmonary disease (p = 0.005), and a history of coronary artery disease (p = 0.03). No significant difference was noted between the 2 groups with regard to the left ventricular ejection fraction. The 2-year cumulative survival rate was 76.6% for patients with PAD and 94.1% for those with isolated coronary disease (p <0.001). In conclusion, after adjusting all significant variables, the presence of PAD appeared as an independent predictive factor for all-cause mortality (adjusted hazard ratio 3.2, 95% confidence interval 1.8 to 5.7, p = 0.001).
authors.affiliation: Department of Cardiology, University Hospital Nancy, Vandoeuvre les Nancy, France. b.popovic@chu-nancy.fr
authors.forename: Batric
authors.initials: B
authors.lastname: Popovic
authors.forename: Marc Antoine
authors.initials: MA
authors.lastname: Arnould
authors.forename: Christine
authors.initials: C
authors.lastname: Selton-Suty
authors.forename: Clotilde
authors.initials: C
authors.lastname: Latarche
authors.forename: Michael
authors.initials: M
authors.lastname: Angioi
authors.forename: Jean Pierre
authors.initials: JP
authors.lastname: Carteaux
authors.forename: Jean Pierre
authors.initials: JP
authors.lastname: Villemot
authors.forename: Etienne
authors.initials: E
authors.lastname: Aliot
mesh_terms: D000367:Age Factors; D000368:Aged; D050197:Atherosclerosis / Q000401:mortality*; D001026:Coronary Artery Bypass; D003324:Coronary Artery Disease / Q000401:mortality* / Q000628:therapy*; D017707:Erythrocyte Transfusion / Q000706:statistics & numerical data; D005260:Female; D005500:Follow-Up Studies; D005602:France / Q000453:epidemiology; D006801:Humans; D006973:Hypertension / Q000453:epidemiology; D007674:Kidney Diseases / Q000453:epidemiology; D008171:Lung Diseases / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000453:epidemiology; D012737:Sex Factors; D020521:Stroke / Q000453:epidemiology; D013318:Stroke Volume; D013530:Surgical Wound Infection / Q000453:epidemiology; D015996:Survival Rate