title: Aortic sclerosis is associated with mortality and major morbidity in patients undergoing coronary artery bypass surgery.
abstract: OBJECTIVE
  In this study, we aim to investigate the association between aortic sclerosis and mortality and major morbidity in patients with established coronary artery disease undergoing coronary artery bypass grafting (CABG).
  
  
  METHODS
  Preoperative echocardiograms of consecutive patients undergoing isolated CABG between 2007 and 2009 (n=1150) were analysed, excluding patients without an echocardiogram in the 30 days prior to surgery (n=483). Using logistic regression, we evaluated the association between aortic sclerosis and inhospital mortality and major morbidity. Using Cox proportional hazards, the effect on long-term all-cause mortality was determined.
  
  
  METHODS
  Massachusetts General Hospital, Boston.
  
  
  METHODS
  Patients undergoing isolated CABG between 2007 and 2009.
  
  
  METHODS
  Analysis of echocardiograms.
  
  
  METHODS
  Inhospital mortality and major morbidity, and long-term all-cause mortality.
  
  
  RESULTS
  627 patients were suitable for enrolment; 207 (33%) had significant aortic sclerosis. These patients had higher rates of traditional cardiovascular risk factors. Significant aortic sclerosis was associated with an increased risk of inhospital mortality or major morbidity (OR 1.95; 95% CI 1.25 to 3.04). Following adjustment for baseline clinical and echocardiographic variables, the association remained significant (OR 1.90; 95% CI 1.15 to 3.11). The HR for adjusted all-cause mortality was 2.52 (mean follow-up 2.7 years).
  
  
  CONCLUSIONS
  Aortic sclerosis is a common finding in patients undergoing CABG. In these patients, its presence is associated with a higher risk of inhospital mortality or major morbidity, and is associated with a higher risk of all-cause long-term mortality independent of other risk factors.
authors.affiliation: Cardiac Ultrasound Laboratory, Division of Cardiology, Massachusetts General Hospital, Harvard University, 55 Fruit Street, Boston, MA 02114, USA.
authors.forename: Aidan W
authors.initials: AW
authors.lastname: Flynn
authors.forename: Jonathan
authors.initials: J
authors.lastname: Afilalo
authors.forename: Arvind K
authors.initials: AK
authors.lastname: Agnihotri
authors.forename: Cristina
authors.initials: C
authors.lastname: Castrillo
authors.forename: David M
authors.initials: DM
authors.lastname: Shahian
authors.forename: Michael H
authors.initials: MH
authors.lastname: Picard
mesh_terms: D000368:Aged; D001018:Aortic Diseases / Q000150:complications* / Q000175:diagnosis / Q000401:mortality; D050197:Atherosclerosis / Q000150:complications* / Q000000981:diagnostic imaging / Q000401:mortality; D002423:Cause of Death / Q000639:trends; D001026:Coronary Artery Bypass; D003324:Coronary Artery Disease / Q000150:complications / Q000401:mortality* / Q000601:surgery; D004452:Echocardiography; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008404:Massachusetts / Q000453:epidemiology; D012189:Retrospective Studies; D012307:Risk Factors; D015996:Survival Rate / Q000639:trends