In-hospital and long-term outcomes of coronary artery bypass graft surgery in patients ≤ 45 years of age and older (from the KROK registry)

Abstract

Background: 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.

Aim: We aimed to compare the clinical characteristics, and in-hospital and long-term outcomes of patients ≤ 45 years and > 45 years old, who underwent isolated CABG.

Methods: We identified consecutive patients who had isolated CABG in the Department of Cardiac Surgery and Transplantology in the Silesian Centre 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).

Results: Patients ≤ 45 years old 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 old 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 revascularisation (55.4% vs. 18.1%, p < 0.0001). There were no significant differences between the groups regarding 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 old 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 a lower mortality rate in the long-term follow-up.