Document Type : Original Article
Author
Prevention of Cardiovascular Disease Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Abstract
Background and aim: Regarding the significantly increased rate of the aged population, the incidence of age-related diseases is inevitable too. This study aimed to evaluate the impact on early-term and long-term outcomes of coronary artery bypass grafting (CABG) in elderly versus younger patients.
Patients and Methods: This observational case-control study was conducted on 535 patients divided into two groups: older adults >75 years and younger adults <75 years. All patients underwent CABG with a similar protocol. The primary endpoints were to assess early post-procedure outcomes, including in-hospital mortality and total length of ICU or hospital stay. The patients followed up for six months. The secondary study endpoints included long-term death, left ventricular ejection fraction, need for re-hospitalization, and repeated revascularization.
Results: In total, 535 patients who underwent CABG were enrolled in this study. Smoking habit is significantly higher among younger adults (38.2% vs. 12.5% P=0.001). Hypertension is most prevalent among older adults (75% vs. 60% P=0.044). LDL cholesterol Serum was higher among younger adult patients (94.9±32.5, 80.9±32.9 P=0.028). The serum creatinine level was lower among younger adults 1.5±1.1 vs. 1.9±2.2, P=0.057). Significant differences were seen in the length of ICU stay (6.8±3.4 vs. 8.4±3, P=0.006) between the two groups. In-hospital death was not significantly different between younger and older adults, (2.8% vs. 5%, P=0.34). Mortality in the six month follow-up was non-significantly higher in the elderly (2.1% vs. 8.1%, P=0.06).
Conclusion: In current clinical practice, CABG should be considered a feasible decision for elderly patients with reasonable operative risk.
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