title: Symptomatic peripheral artery disease is associated with decreased long-term survival after coronary artery bypass: a contemporary retrospective analysis.
abstract: OBJECTIVE
  Little has been documented about whether the severity of peripheral artery disease (PAD) affects the postoperative outcomes of coronary artery bypass grafting (CABG).
  
  
  METHODS
  We performed a retrospective analysis of 683 patients who underwent isolated CABG, comparing preoperative profiles and postoperative outcomes between patients with PAD (n = 116) and those without PAD (n = 567). Kaplan-Meier analysis was done to examine the long-term survival and the Cox proportional hazard model was used to establish the preoperative risk factors associated with survival.
  
  
  RESULTS
  The PAD patients were older and had more preoperative comorbidities than those without PAD. There were three operative deaths in each group (p = 0.07). The patients with PAD had more postoperative complications related to transfusion requirement (p = 0.004), the need for re-exploration for bleeding (p = 0.04), longer ventilation time (p < 0.001), and longer ICU stay (p = 0.001), than those without PAD. The 10-year survival rate of the PAD patients was lower than that of the non-PAD patients (p < 0.001). Univariate and multivariate analyses revealed that symptomatic PAD (p = 0.008) was associated with decreased long-term survival.
  
  
  CONCLUSIONS
  Symptomatic PAD was found to be an independent factor for poor long-term survival after CABG. Thus, aggressive screening measures for coronary disease, early surgical revascularization, and secondary prevention may improve the early and long-term outcomes of these patients.
authors.affiliation: Department of Cardiovascular Surgery, Osaka University Graduate School of Medicine, 2-2 Yamada-oka, Suita, 565-0871, Japan.
authors.forename: Teruya
authors.initials: T
authors.lastname: Nakamura
authors.affiliation: Department of Cardiovascular Surgery, Osaka University Graduate School of Medicine, 2-2 Yamada-oka, Suita, 565-0871, Japan.
authors.forename: Koichi
authors.initials: K
authors.lastname: Toda
authors.affiliation: Department of Cardiovascular Surgery, Osaka University Graduate School of Medicine, 2-2 Yamada-oka, Suita, 565-0871, Japan.
authors.forename: Shigeru
authors.initials: S
authors.lastname: Miyagawa
authors.affiliation: Department of Cardiovascular Surgery, Osaka University Graduate School of Medicine, 2-2 Yamada-oka, Suita, 565-0871, Japan.
authors.forename: Yasushi
authors.initials: Y
authors.lastname: Yoshikawa
authors.affiliation: Department of Cardiovascular Surgery, Osaka University Graduate School of Medicine, 2-2 Yamada-oka, Suita, 565-0871, Japan.
authors.forename: Satsuki
authors.initials: S
authors.lastname: Fukushima
authors.affiliation: Department of Cardiovascular Surgery, Osaka University Graduate School of Medicine, 2-2 Yamada-oka, Suita, 565-0871, Japan.
authors.forename: Shunsuke
authors.initials: S
authors.lastname: Saito
authors.affiliation: Department of Cardiovascular Surgery, Osaka University Graduate School of Medicine, 2-2 Yamada-oka, Suita, 565-0871, Japan.
authors.forename: Daisuke
authors.initials: D
authors.lastname: Yoshioka
authors.affiliation: Department of Cardiovascular Surgery, Osaka University Graduate School of Medicine, 2-2 Yamada-oka, Suita, 565-0871, Japan.
authors.forename: Shin
authors.initials: S
authors.lastname: Yajima
authors.affiliation: Department of Cardiovascular Surgery, Osaka University Graduate School of Medicine, 2-2 Yamada-oka, Suita, 565-0871, Japan.
authors.forename: Shohei
authors.initials: S
authors.lastname: Yoshida
authors.affiliation: Department of Cardiovascular Surgery, Osaka University Graduate School of Medicine, 2-2 Yamada-oka, Suita, 565-0871, Japan. sawasec@surg1.med.osaka-u.ac.jp.
authors.forename: Yoshiki
authors.initials: Y
authors.lastname: Sawa
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001803:Blood Transfusion / Q000706:statistics & numerical data; D001026:Coronary Artery Bypass / Q000401:mortality*; D003324:Coronary Artery Disease / Q000150:complications* / Q000601:surgery*; D005260:Female; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D058729:Peripheral Arterial Disease / Q000150:complications*; D011183:Postoperative Complications / Q000453:epidemiology / Q000209:etiology*; D012189:Retrospective Studies; D012720:Severity of Illness Index; D015996:Survival Rate; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult
keywords: Coronary artery bypass; Coronary artery disease; Peripheral artery disease