The Impact of Age on Clinical Outcomes of Coronary Artery Bypass Grafting: Long-Term Results of a Real-World Registry

被引:20
|
作者
Nicolini, Francesco [1 ]
Fortuna, Daniela [2 ]
Contini, Giovanni Andrea [3 ]
Pacini, Davide [4 ]
Gabbieri, Davide [5 ]
Zussa, Claudio [6 ]
De Palma, Rossana [2 ]
Vezzani, Antonella [3 ]
Gherli, Tiziano [1 ]
机构
[1] Univ Parma, Dept Med & Surg, Cardiac Surg Unit, Parma, Italy
[2] Reg Agcy Hlth & Social Care, Emilia Romagna, Italy
[3] Parma Hosp, Surg Dept, Cardiac Surg Unit, Parma, Italy
[4] Univ Hosp S Orsola Malpighi, Cardiothorac Vasc Dept, Bologna, Italy
[5] Hesperia Hosp, Dept Clin Cardiol & Thoraco Vasc Surg, Modena, Italy
[6] Villa Maria Cecilia Hosp, Dept Cardiol & Cardiac Surg, Lugo, Ravenna, Italy
关键词
BODY-MASS INDEX; MYOCARDIAL-INFARCTION; RISK-FACTORS; DISEASE; SURGERY; YOUNG; INTERVENTION; METAANALYSIS; REVASCULARIZATION; ASSOCIATION;
D O I
10.1155/2017/9829487
中图分类号
Q81 [生物工程学(生物技术)]; Q93 [微生物学];
学科分类号
071005 ; 0836 ; 090102 ; 100705 ;
摘要
The aim of this retrospective multicenter registry study was to investigate age-dependent trends in mortality, long-term survival, and comorbidity over time in patients who underwent isolated CABG from 2003 to 2015. The percentage of patients <60 years of age was 18.9%. Female sex, chronic pulmonary disease, extracardiac arteriopathy, and neurologic dysfunction disease were significantly less frequent in this younger population. The prevalence of BMI >= 30, previous myocardial infarction, preoperative severe depressed left ventricular ejection fraction, and history of previous PCI were significantly higher in this population. After PS matching, at 5 years, patients <60 years of age reported significantly lower overall mortality (p < 0.0001), cardiac-related mortality (p < 0.0001), incidence of acute myocardial infarction (p = 0.01), and stroke rates (p < 0.0001). Patients < 60 years required repeated revascularization more frequently than older patients (p = 0.05). Patients <60 who underwent CABG had a lower risk of adverse outcomes than older patients. Patients <60 have a different clinical pattern of presentation of CAD in comparison with more elderly patients. These issues require focused attention in order to design and improve preventive strategies aiming to reduce the impact of specific cardiovascular risk factors for younger patients, such as diet, lifestyle, and weight control.
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页数:11
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