title: The effect of race and chronic obstructive pulmonary disease on long-term survival after coronary artery bypass grafting.
abstract: BACKGROUND
  Chronic obstructive pulmonary disease (COPD) is a known predictor of decreased long-term survival after coronary artery bypass grafting (CABG). Differences in survival by race have not been examined.
  
  
  METHODS
  A retrospective cohort study was conducted of CABG patients between 2002 and 2011. Long-term survival was compared in patients with and without COPD and stratified by race. Hazard ratios (HR) and 95% confidence intervals (CI) were computed using a Cox regression model.
  
  
  RESULTS
  A total of 984 (20%) patients had COPD (blackn= 182; whiten= 802) at the time of CABG (N= 4,801).The median follow-up for study participants was 4.4 years. COPD was observed to be a statistically significant predictor of decreased survival independent of race following CABG (no COPD: HR = 1.0; white COPD: adjusted HR = 1.9, 95% CI = 1.7-2.3; black COPD: adjusted HR = 1.6, 95% CI = 1.1-2.2).
  
  
  CONCLUSIONS
  Contrary to the expected increased risk of mortality among black COPD patients in the general population, a similar survival disadvantage was not observed in our CABG population.
authors.affiliation: Department of Cardiovascular Sciences, East Carolina Heart Institute, Brody School of Medicine, East Carolina University, Greenville, NC, USA ; Center for Health Disparities Research, Brody School of Medicine, East Carolina University, Greenville, NC, USA.
authors.forename: Jimmy T
authors.initials: JT
authors.lastname: Efird
authors.forename: Wesley T
authors.initials: WT
authors.lastname: O'Neal
authors.forename: Curtis A
authors.initials: CA
authors.lastname: Anderson
authors.forename: Jason B
authors.initials: JB
authors.lastname: O'Neal
authors.forename: Linda C
authors.initials: LC
authors.lastname: Kindell
authors.forename: T Bruce
authors.initials: TB
authors.lastname: Ferguson
authors.forename: W Randolph
authors.initials: WR
authors.lastname: Chitwood
authors.forename: Alan P
authors.initials: AP
authors.lastname: Kypson
keywords: CABG; COPD; long-term; race; survival