This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Hillis, G. S. Articles by Oh, J. K. Search for Related Content PubMed PubMed Citation Articles by Hillis, G. S. Articles by Oh, J. K. Related Collections CV surgery: coronary artery disease Chronic ischemic heart disease

(Circulation. 2006;114:I-414 – I-419.)
© 2006 American Heart Association, Inc.

Surgery for Coronary Artery Disease

Outcome of Patients With Low Ejection Fraction Undergoing Coronary Artery Bypass Grafting

Renal Function and Mortality After 3.8 Years

Graham S. Hillis, MBChB, PhD; Kenton J. Zehr, MD; Amy W. Williams, MD; Hartzell V. Schaff, MD; Thomas A. Orzulak, MD; Richard C. Daly, MD; Charles J. Mullany, MD; Richard J. Rodeheffer, MD; Jae K. Oh, MD

From the Divisions of Cardiovascular Disease (G.S.H., R.J.R, J.K.O.), Nephrology (A.W.W) and Cardiovascular Surgery (K.J.Z., H.V.S., T.A.O., R.C.D., C.J.M.), Mayo Clinic, Rochester, Minn.

Correspondence to Jae Oh, Division of Cardiovascular Diseases, Mayo Clinic, 200 First Street SW, Rochester, MN 55905. E-mail oh.jae{at}mayo.edu

Background— There are few data regarding medium-term outcome of coronary artery bypass grafting (CABG) in patients with severe left ventricular (LV) systolic dysfunction, particularly in the modern era, and even less assessing preoperative factors that might identify patients at highest risk.

Methods and Results— Three hundred seventy-nine consecutive patients with LV ejection fraction 35%, who underwent isolated first CABG between 1995 and 1999 were studied. Potential preoperative and perioperative predictors of outcome were recorded and patients followed-up for a median of 3.8 years. The primary study end-point was all-cause mortality. The 30-day, 1-year, and 3-year survival rates were 94.5%, 88%, and 81%, respectively. The independent predictors of mortality were preoperative estimated glomerular filtration rate (hazard ratio [HR], 0.98; 95% confidence interval [CI], 0.97 to 0.99 per mL/min/1.73m²; P<0.001) and age (HR, 1.03; 95% CI, 1.01 to 1.06 per year; P=0.005).

Conclusions— Patients with significant LV systolic dysfunction undergoing isolated CABG using contemporary techniques have a good medium-term survival. Renal dysfunction is the strongest independent predictor of mortality.

Key Words: coronary disease • kidney • surgery • survival