Kardiologia polska 2017 05 29() doi 10.5603/KP.a2017.0090
There is a paucity of data concerning the clinical characteristics, management and outcomes of coronary artery bypass graft surgery (CABG) in patients ≤45 years old.
We aimed to compare the clinical characteristics, in-hospital and long-term outcomes of patients ≤45 years and >45 years who underwent isolated CABG.
We identified consecutive patients who had isolated CABG in Department of Cardiac Surgery and Transplantology in Silesian Center for Heart Diseases in Zabrze between January 2006 and December 2011 and were enrolled in the Polish National Registry of Cardiac Surgery Procedures (KROK registry). A total of 8196 patients were identified and split into two groups, age ≤45 years old (young group) (n=130) and >45 years old (old group) (n=8066).
Patients £45 years were less often females (18.5% vs. 27.6%, p<0.027), more often smokers (84.6% vs. 66.9%, p<0.0001) and had a higher incidence of previous myocardial infarction (MI) (40.8% vs. 29.6%, p=0.008). Patients £45 years more often received only one graft (27.7% vs. 15.0%, p<0.0001), were operated on with minimally invasive direct coronary artery bypass (MIDCAB) technique (12.3% vs. 3.9%, p<0.0001) and had complete arterial revascularization (55.4% vs. 18.1%, p<0.0001). There were no significant differences between the groups in in-hospital mortality (0.8% vs 1.4%, p=0.808). Long term outcomes revealed that young patients compared with the older patients showed no significant differences in the number of MI (4.6% vs. 5.6%), unstable angina (8.5% vs. 9.9%), coronary angioplasty (12.3% vs. 15.1%), reCABG (0.8% vs. 0.1%), and strokes (2.3% vs. 4.3%) during the follow-up period, long term mortality occurred less often in the young patients (4.6% vs. 15.0%, p=0.002). CONCLUSIONS
We conclude that patients £45 years requiring CABG differ from their older counterparts in clinical and surgical characteristics. We noted no significant differences in the in-hospital mortality, however patients £45 years old had lower mortality rate in the long term follow up.