title: [Results and predictors of long-term outcomes of off-pump coronary artery bypass grafting: 2 831 cases from a single center].
abstract: OBJECTIVE
  To describe the long-term survival of off-pump coronary artery bypass grafting (CABG) and to analysis the risk factors of operative mortality and long-term survival.
  
  
  METHODS
  From January 2001 to December 2012, 2 831 patients undergoing off-pump CABG in Peking University People's Hospital, 2 099 cases (74.1%) of them were male, the average age was (63±9) years. The perioperative data was retrospectively collected. Binary Logistic regression was used to find the risk factors which affect the operative mortality. Follow-up evaluation was completed regularly. Kaplan-Meier survival curve, Log-rank test and Cox regression model were used to find out factors which affect the long-term result.
  
  
  RESULTS
  Totally 2 831 patients underwent isolating off-pump CABG, in whom 45 patients died perioperative, 2 786 patients discharged successfully. Binary Logistic regression showed that sex (female) (χ2=4.4, OR=2.307, P=0.035), peripheral vascular disease (χ2=17.4, OR=6.616, P=0.000), New York Heart Association (NYHA) class grade≥3 (χ2=10.5, OR=3.491, P=0.001), ejection fraction≤40% (χ2=16.9, OR=5.230, P=0.000), emergency surgery (χ2=11.9, OR=5.127, P=0.001) are risk factors of operative mortality. The follow-up time was (74±44) months. Totally 107 patients were lost from follow-up, 109 patients died in follow-up. The survival rate at 1, 3, 5 , 8 and 10 years was 97.2%, 95.5%, 94.3%, 93.6%, 92.1%, respectively. Univariate analysis showed that age (>65 years), hypertension, renal insufficiency, peripheral vascular disease, history of myocardial infarction, NYHA class grade≥3 and emergency surgery were risk factors of the long-term survival (χ2=8.150 to 88.241, P<0.05). Cox regression analysis showed that age (>65 years) (χ2=12.1, RR=2.295, P=0.000), renal insufficiency (χ2=12.3, RR=3.160, P=0.000), peripheral vascular disease (χ2=42.5, RR=5.626, P=0.000), NYHA class grade≥3 (χ2=9.1, RR=1.994, P=0.002) and emergency surgery (χ2=5.5, RR=2.247, P=0.019) were independent risk factors that affect the long-term survival.
  
  
  CONCLUSIONS
  Sex (female), peripheral vascular disease, NYHA class grade≥3, ejection fraction≤40%, emergency surgery are risk factors of operative mortality. Age (>65 years), renal insufficiency, peripheral vascular disease, NYHA class grade≥3 and emergency surgery are independent risk factors that affect the long-term survival. Off-pump CABG has favorable perioperative and long-term outcome, and it definitely is a very safe and effective technique for coronary artery revascularization.
authors.affiliation: Department of Cardiovascular Surgery, Peking University People's Hospital, Beijing 100044, China.
authors.forename: Xi
authors.initials: X
authors.lastname: Liu
authors.affiliation: Department of Cardiovascular Surgery, Peking University People's Hospital, Beijing 100044, China; Email: chenyu@pkuph.edu.cn.
authors.forename: Yu
authors.initials: Y
authors.lastname: Chen
authors.affiliation: Department of Cardiovascular Surgery, Peking University People's Hospital, Beijing 100044, China.
authors.forename: Zhou
authors.initials: Z
authors.lastname: Zhao
authors.affiliation: Department of Cardiovascular Surgery, Peking University People's Hospital, Beijing 100044, China.
authors.forename: Suixin
authors.initials: S
authors.lastname: Dong
authors.affiliation: Department of Cardiovascular Surgery, Peking University People's Hospital, Beijing 100044, China.
authors.forename: Gang
authors.initials: G
authors.lastname: Liu
authors.affiliation: Department of Cardiovascular Surgery, Peking University People's Hospital, Beijing 100044, China.
authors.forename: Shenglong
authors.initials: S
authors.lastname: Chen
authors.affiliation: Department of Cardiovascular Surgery, Peking University People's Hospital, Beijing 100044, China.
authors.forename: Yunpeng
authors.initials: Y
authors.lastname: Ling
authors.affiliation: Department of Cardiovascular Surgery, Peking University People's Hospital, Beijing 100044, China.
authors.forename: Hui
authors.initials: H
authors.lastname: Li
authors.affiliation: Department of Cardiovascular Surgery, Peking University People's Hospital, Beijing 100044, China.
authors.forename: Bo
authors.initials: B
authors.lastname: Lian
authors.affiliation: Department of Cardiovascular Surgery, Peking University People's Hospital, Beijing 100044, China.
authors.forename: Liming
authors.initials: L
authors.lastname: Bao
authors.affiliation: Department of Cardiovascular Surgery, Peking University People's Hospital, Beijing 100044, China.
authors.forename: Wei
authors.initials: W
authors.lastname: Yang
mesh_terms: D000368:Aged; D002318:Cardiovascular Diseases; D047549:Coronary Artery Bypass, Off-Pump / Q000401:mortality*; D003324:Coronary Artery Disease / Q000601:surgery*; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction; D016491:Peripheral Vascular Diseases; D012189:Retrospective Studies; D012307:Risk Factors; D016896:Treatment Outcome