Abstract 10372: Trends in Incidence of Heart Failure Admissions After Coronary Artery Bypass Grafting Surgery
Background: Coronary Artery Bypass Grafting (CABG) is commonly used to treat coronary artery disease (CAD). The factors related to admissions for heart failure (HF) after CABG surgery have not been well studied.
Methods: Patients who had CABG from 1998 to 2007 (n=65,377) were analyzed using the New Jersey Myocardial Infarction Data Acquisition System (MIDAS). Patients were categorized into four groups based on their pre-operative ejection fractions (EF) (<25%, 25-34%, 35-49%, and ≥50%). Multivariate proportional hazard models were used to identify factors related to post-CABG HF hospitalizations and mortality.
Results: Independent factors associated with HF admissions within 1 year post-CABG were: EF hazard ratio (HR) 2.0 (1.8-2.2); age HR 1.03 (1.03-1.03); female HR 1.4 (1.3-1.5); black HR 1.2 (1.1-1.4); diabetes HR 1.4 (1.4-1.5); renal disease HR 1.6 (1.5-1.7); hypertension HR 1.1 (1.0-1.2); stroke HR 1.2 (1.2-1.3); smoking HR 1.2 (1.1-1.3). The use of beta-blocker (BB) decreased the risk of HF by 13%, and the benefit was greater in the lower EF groups (Table 2). The use of BB increased in all EF groups over the years (p<0.0001). HF admission rates in the lower EF groups (≤34%) increased in the later years (p=0.02), whereas no significant changes were observed for patients with EF ≥35% (p=0.1).
Conclusions: EF remains a strong predictor of HF admission and long-term mortality even after CABG. BB use significantly decreased HF admission rates. Despite the more pronounced benefit and increasing use of BB in lower EF groups, their post-CABG HF admission rates are still rising. This suggests that more effective clinical management is necessary for these patients.
- © 2011 by American Heart Association, Inc.