Late Results of Coronary Artery Bypass Surgery with Maximal Follow-Up of 7 Years: Analysis of Determinants Affecting Late Survival

Abstract

A total of 806 primary coronary artery bypass graft operations were performed between January 1984 and December 1989. Excluding eight hospital deaths (1.0%) and three patients lost in follow-up, a total of 795 patients were contacted, with a follow-up rate of 99.6%. The mean follow-up period was 53.6 months, the longest being 92 months. Of the patients 42 died in late follow-up. Malignant neoplasm was the major cause of death (n = 17, 40% of total late deaths), which far exceeded the number of cardiac deaths (n = 6, 14%). The actuarial survival, excluding the initial hospital deaths, was 95% at 5 years and 91% at 7 years by the Kaplan-Meier method. By multivariate logistic analysis, four clinical variables were identified as significant in influencing the late survival, in the following order: (1) presence or absence of diabetes mellitus (P = 0.00008); (2) age ≥65 years or <65 years (P = 0.002); (3) left ventricular function with ejection fraction <45% or ≥45% (P = 0.014); and (4) use or non-use of left internal mammary arteries to bypass the left anterior descending artery (P = 0.016). Sex (male versus female), severity of anginal symptoms (mild versus severe) and number of diseased vessels (single and double versus triple vessel and left main trunk disease) did not significantly influence the late survival of the patients.