title: Incidence and trends of heart failure admissions after coronary artery bypass grafting surgery.
abstract: OBJECTIVE
  Factors related to hospitalization for heart failure (HF) following coronary artery bypass grafting (CABG) surgery were studied.
  
  
  RESULTS
  Patients (n = 65 377) undergoing CABG surgery in New Jersey from 1998 to 2007 were identified from the state cardiac surgery database; subsequent hospitalizations for HF were assessed using the Myocardial Infarction Data Acquisition System database. Patients were classified based on pre-operative ejection fraction (EF). Multivariate models were used to identify factors related to HF admission and mortality. Post-CABG HF admission rates among patients with pre-operative EF <35% increased over the 10-year period (P = 0.02), but no significant trend was seen among patients with EF ≥35%. Independent factors associated with post-CABG HF admission within 2 years were: EF, age, female gender, Black race, smoking, diabetes, renal disease, hypertension, and cerebrovascular disease. Pre-operative use of beta-blockers increased over the years (P < 0.0001) and reduced the risk of admission for HF by 13%, with greater benefit in patients with lower EF. Mortality remained unchanged from 1998 to 2007, averaging 1.8% in-hospital and 5.1% and 7.2% at 1-year and 2-year follow-up, respectively.
  
  
  CONCLUSIONS
  Pre-operative EF is a strong predictor of HF admission within 2 years after CABG surgery. The use of beta-blockers decreased HF admission after CABG, especially in patients with EF <35%. Despite the more pronounced benefit and increasing use of beta-blockers in patients with a low EF, HF admission rates in this group of patients are rising. This suggests that more comprehensive management of factors associated with HF is necessary.
authors.affiliation: Cardiovascular Institute of New Jersey and Department of Medicine, University of Medicine and Dentistry of New Jersey-Robert Wood Johnson Medical School, New Brunswick, NJ 08901, USA. moreyrae@umdnj.edu
authors.forename: Abel E
authors.initials: AE
authors.lastname: Moreyra
authors.forename: Yingzi
authors.initials: Y
authors.lastname: Deng
authors.forename: Alan C
authors.initials: AC
authors.lastname: Wilson
authors.forename: Nora M
authors.initials: NM
authors.lastname: Cosgrove
authors.forename: William J
authors.initials: WJ
authors.lastname: Kostis
authors.forename: John B
authors.initials: JB
authors.lastname: Kostis
mesh_terms: D000368:Aged; D001026:Coronary Artery Bypass / Q000009:adverse effects*; D003324:Coronary Artery Disease / Q000503:physiopathology / Q000601:surgery*; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D006333:Heart Failure / Q000453:epidemiology* / Q000209:etiology / Q000503:physiopathology; D006801:Humans; D015994:Incidence; D008297:Male; D009515:New Jersey / Q000453:epidemiology; D010343:Patient Admission; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors; D013318:Stroke Volume