title: Five-Year Outcome after Coronary Artery Bypass Surgery in Survivors of Out-of-Hospital Cardiac Arrest.
abstract: OBJECTIVE
  The aim of this study was to evaluate the role of coronary artery bypass grafting (CABG) in patients with out-of-hospital cardiac arrest (OHCA).
  
  
  METHODS
  The immediate and 5-year outcome after CABG of a consecutive series of 48 patients who survived OHCA was compared with those of control patients having had a recent myocardial infarction without ventricular arrhythmias.
  
  
  RESULTS
  All OHCA patients were found to have suffered myocardial infarction-related cardiac arrest. The mean delay from OHCA to CABG was 10.3 ± 13.0 days. Despite not statistically significant, the risk of 30-day postoperative mortality was higher among OHCA patients than control patients (6.3 vs. 0%, p = 0.24, propensity score adjusted analysis: p = 1.00). Cardioverter defibrillator was implanted in two patients who were alive 3.8 and 4.4 years after CABG, respectively. At 5-year, the overall survival rate was 80.7% in OHCA patients and 84.5% in control patients (p = 0.98, propensity score adjusted analysis: p = 0.87), and survival freedom from fatal cardiac event was 86.1% in OHCA patients and 86.5% in control patients (p = 0.61; propensity score adjusted analysis: p = 0.90).
  
  
  CONCLUSIONS
  Early and 5-year survival rates after CABG in OHCA patients are excellent even when cardioverter defibrillator is very selectively implanted. The early and intermediate results CABG suggest a confident approach toward surgical revascularization in this critically ill patient population.
authors: Department of Surgery, Oulu University Hospital , Oulu , Finland.
authors: Matti-Aleksi
authors: MA
authors: Mosorin
authors: Department of Surgery, Oulu University Hospital , Oulu , Finland.
authors: Maté
authors: M
authors: Lantos
authors: Department of Surgery, Oulu University Hospital , Oulu , Finland.
authors: Tatu
authors: T
authors: Juvonen
authors: Department of Surgery, Oulu University Hospital , Oulu , Finland.
authors: Fausto
authors: F
authors: Biancari
keywords: cardiac arrest; coronary artery bypass surgery; myocardial infarction; myocardial revascularization; out-of-hospital cardiac arrest
references: World J Surg. 2010 Dec;34(12):2979-84
references: 20811745
references: Eur J Cardiothorac Surg. 2009 Nov;36(5):799-804
references: 19523840
references: Circ Cardiovasc Interv. 2010 Jun 1;3(3):200-7
references: 20484098
references: Am Heart J. 2009 Mar;157(3):569-575.e1
references: 19249431
references: J Am Coll Cardiol. 1990 Feb;15(2):267-73
references: 2299065
references: J Am Coll Cardiol. 1992 Jun;19(7):1435-9
references: 1593036
references: J Invasive Cardiol. 2009 Jan;21(1):1-5
references: 19126919
references: Ann Thorac Surg. 2002 Nov;74(5):1510-6
references: 12440601
references: Eur J Cardiothorac Surg. 1999 Jul;16(1):9-13
references: 10456395
references: Pacing Clin Electrophysiol. 1994 Mar;17(3 Pt 2):552-8
references: 7513886