title: Comparison of the Effects of Coronary Artery Bypass Grafting Versus Medical Therapy on Short and Long Term Outcomes in Octogenarian Patients With Multi-Vessel Coronary Artery Disease.
abstract: BACKGROUND
  Appropriate treatment methods lead to a reduced rate of mortality and morbidity, and an improved quality of life, in patients with multi-vessel coronary artery disease.
  
  
  OBJECTIVE
  In this study, we compared short and long-term outcomes of coronary artery bypass grafting (CABG) versus medical therapy in patients 80 years of age and older with multi-vessel coronary artery disease (MVCAD).
  
  
  METHODS
  In this retrospective study, 50 octogenarian patients with MVCAD who underwent CABG were compared with 50 patients in the same condition who were treated with medical therapy during the same time. The primary objective was to compare mortality and morbidity rates, as well as other factors such as the occurrence of chest pain, deterioration of the NYHA functional class, and re-hospitalization, between the two groups. The comparison was made using medical records from the five years post-treatment.
  
  
  RESULTS
  After five years, the overall mortality rate included 11 patients (22%) in the CABG group versus 18 patients (36%) in the medical therapy group; this difference was not significant between the two groups (P = 0.186). Regarding short-term outcomes, in the CABG group, cardiogenic shock occurred in 9 patients (18%), renal failure in 13 patients (26%), pulmonary complications in 9 patients (18%) and neurologic complications in 3 patients (6%); in the medical therapy group, these same complications occurred, respectively, in 6 patients (12%), 7 patients (14%), 10 patients (20%) and 1 patient (2%). In addition to these factors, freedom from chest pain and improvement in the functional class among the CABG group was significantly higher than among the medical therapy group (P = <0.001).
  
  
  CONCLUSIONS
  CABG may be the superior form of treatment for long-term outcomes in terms of the relief of chest pain, improvement of the functional class, reduced need for re-admission, and later death for octogenarians. However, short-term morbidity may be higher among the CABG group, but the mortality rate after 30 days is quite similar.
authors.affiliation: Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, IR Iran.
authors.forename: Azin
authors.initials: A
authors.lastname: Alizadehasl
authors.affiliation: Madani Cardiovascular Medical and Research Center, Tabriz University of Medical Sciences, Tabriz, IR Iran.
authors.forename: Bahram
authors.initials: B
authors.lastname: Sohrabi
authors.affiliation: Madani Cardiovascular Medical and Research Center, Tabriz University of Medical Sciences, Tabriz, IR Iran.
authors.forename: Laleh
authors.initials: L
authors.lastname: Panjavi
authors.affiliation: Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, IR Iran.
authors.forename: Anita
authors.initials: A
authors.lastname: Sadeghpour
authors.affiliation: Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, IR Iran.
authors.forename: Rasoul
authors.initials: R
authors.lastname: Azarfarin
authors.affiliation: Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, IR Iran.
authors.forename: Behshid
authors.initials: B
authors.lastname: Ghadrdoost
authors.affiliation: Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, IR Iran.
authors.forename: Reza
authors.initials: R
authors.lastname: Zolfaghari
authors.affiliation: Madani Cardiovascular Medical and Research Center, Tabriz University of Medical Sciences, Tabriz, IR Iran.
authors.forename: Afshin
authors.initials: A
authors.lastname: Habibzadeh
keywords: Coronary Artery Bypass Surgery; Coronary Artery Disease; Drug Therapy; Outcome Study