PDF(Pubmed)
Abstract：
BACKGROUND: The types of graft conduits and surgical techniques may impact the long-term outcomes of patients after coronary artery bypass graft (CABG) revascularization. This study observed a long-term survival rate following CABG surgery over 20 years in the United Kingdom.
METHODS: A total of 2979 isolated CABG patients were studied from 1999 to 2020, and postoperative data were obtained from the hospital-recorded mortality by the data quality team of the information department. Postdischarge survival was estimated using the Kaplan-Meier method, and statistical significance was obtained with log-rank tests and the Gehan-Breslow test, and the Holm-Sidak method was used for multiple pairwise comparisons.
RESULTS: The study observed male predominance (80%), and the median age was statistically significant (P <0.001) among the groups, 66 years (interquartile range 58-73) and 72 years (interquartile range 66-78) in survivor and non-survivor groups, respectively. In the Holm-Sidak method analysis, the best survival rate (mean 18.7 years) was observed in the total arterial group with significantly decreased survival for the mixed arterial and venous group (mean 16.12 years) and only the vein group (10.44 years). The Cox regression model observed that the New York Heart Association (NYHA) class III-IV (HR 1.57), chest re-exploration (HR 2.14), preoperative dialysis (HR 3.13), and redo surgery (HR 3.04) were potential predictors of the postoperative mortality (P ≤0.05).
CONCLUSIONS: In our series over 20 years, albeit off-pump and on-pump CABG observed similar survival rates, the total arterial myocardial revascularization population has significantly better long-term survival benefits.
METHODS: A total of 2979 isolated CABG patients were studied from 1999 to 2020, and postoperative data were obtained from the hospital-recorded mortality by the data quality team of the information department. Postdischarge survival was estimated using the Kaplan-Meier method, and statistical significance was obtained with log-rank tests and the Gehan-Breslow test, and the Holm-Sidak method was used for multiple pairwise comparisons.
RESULTS: The study observed male predominance (80%), and the median age was statistically significant (P <0.001) among the groups, 66 years (interquartile range 58-73) and 72 years (interquartile range 66-78) in survivor and non-survivor groups, respectively. In the Holm-Sidak method analysis, the best survival rate (mean 18.7 years) was observed in the total arterial group with significantly decreased survival for the mixed arterial and venous group (mean 16.12 years) and only the vein group (10.44 years). The Cox regression model observed that the New York Heart Association (NYHA) class III-IV (HR 1.57), chest re-exploration (HR 2.14), preoperative dialysis (HR 3.13), and redo surgery (HR 3.04) were potential predictors of the postoperative mortality (P ≤0.05).
CONCLUSIONS: In our series over 20 years, albeit off-pump and on-pump CABG observed similar survival rates, the total arterial myocardial revascularization population has significantly better long-term survival benefits.
摘要：
背景：移植导管的类型和手术技术可能会影响冠状动脉旁路移植术（CABG）血运重建后患者的长期预后。这项研究观察到英国CABG手术后20年的长期生存率。
方法：从1999年至2020年，共研究了2979例孤立的CABG患者，并通过信息部门的数据质量小组从医院记录的死亡率获得了术后数据。使用Kaplan-Meier方法估计出院后生存率，用对数秩检验和Gehan-Breslow检验获得统计学意义，并采用Holm-Sidak方法进行多重成对比较。
结果：该研究观察到男性占主导地位（80％），中位年龄在各组间有统计学意义(P<0.001),幸存者和非幸存者组的66年（四分位距58-73）和72年（四分位距66-78），分别。在Holm-Sidak方法分析中，在总动脉组中观察到最好的生存率(平均18.7年),混合动脉和静脉组(平均16.12年)和仅静脉组(10.44年)的生存率显著降低.Cox回归模型观察到纽约心脏协会（NYHA）III-IV级（HR1.57），胸部再探查（HR2.14），术前透析（HR3.13），和重做手术(HR3.04)是术后死亡率的潜在预测因子(P≤0.05).
结论：在我们20多年的系列中，尽管停泵和停泵CABG观察到相似的存活率，总动脉心肌血运重建人群的长期生存获益显著.
方法：从1999年至2020年，共研究了2979例孤立的CABG患者，并通过信息部门的数据质量小组从医院记录的死亡率获得了术后数据。使用Kaplan-Meier方法估计出院后生存率，用对数秩检验和Gehan-Breslow检验获得统计学意义，并采用Holm-Sidak方法进行多重成对比较。
结果：该研究观察到男性占主导地位（80％），中位年龄在各组间有统计学意义(P<0.001),幸存者和非幸存者组的66年（四分位距58-73）和72年（四分位距66-78），分别。在Holm-Sidak方法分析中，在总动脉组中观察到最好的生存率(平均18.7年),混合动脉和静脉组(平均16.12年)和仅静脉组(10.44年)的生存率显著降低.Cox回归模型观察到纽约心脏协会（NYHA）III-IV级（HR1.57），胸部再探查（HR2.14），术前透析（HR3.13），和重做手术(HR3.04)是术后死亡率的潜在预测因子(P≤0.05).
结论：在我们20多年的系列中，尽管停泵和停泵CABG观察到相似的存活率，总动脉心肌血运重建人群的长期生存获益显著.
