Fukui Toshihiro, Tabata Minoru, Matsuyama Shigefumi, Takanashi Shuichiro
Department of Cardiovascular Surgery, Sakakibara Heart Institute, 3-16-1 Asahi-cho, Fuchu, Tokyo, 183-0003, Japan.
Gen Thorac Cardiovasc Surg. 2011 Dec;59(12):786-92. doi: 10.1007/s11748-011-0836-7. Epub 2011 Dec 16.
This study aimed to assess the clinical and angiographic outcomes after coronary artery bypass grafting (CABG) in elderly patients (≥75 years).
We reviewed the records of 1021 patients who underwent CABG between September 2004 and December 2009. We divided these patients into two groups: ≥75 years (group E, n = 292) versus <75 years (group N, n = 729). We compared operative and postoperative variables and early and 1-year angiographic patency rates of grafts between the groups.
The rates of female sex (P < 0.01), unstable angina (P = 0.04), and history of congestive heart failure (P < 0.01) were higher in group E than in group N. More patients in group N had diabetes (P = 0.03) and hyperlipidemia (P < 0.01) than those in group E. Operative mortality (1.0% in group E vs. 0.3% in group N; P = 0.14) and the rate of major complications were not significantly different between the groups. The mean number of anastomoses per patient was similar in the groups. The rate of left internal thoracic artery use was not significantly different between the groups, although the use of other arterial grafts was significantly higher in group N than in group E. There were no significant differences in the early (98.5% vs. 97.2%, P = 0.08) or 1-year (91.6% vs. 89.3%, P = 0.28) patency rates of all grafts in the groups.
The clinical and angiographic outcomes after CABG in elderly patients were almost identical to those in nonelderly patients.
本研究旨在评估老年患者(≥75岁)冠状动脉旁路移植术(CABG)后的临床和血管造影结果。
我们回顾了2004年9月至2009年12月期间接受CABG的1021例患者的记录。我们将这些患者分为两组:≥75岁(E组,n = 292)与<75岁(N组,n = 729)。我们比较了两组之间的手术和术后变量以及移植血管的早期和1年血管造影通畅率。
E组女性比例(P < 0.01)、不稳定型心绞痛(P = 0.04)和充血性心力衰竭病史(P < 0.01)高于N组。N组糖尿病患者(P = 0.03)和高脂血症患者(P < 0.01)比E组更多。两组之间的手术死亡率(E组为1.0%,N组为0.3%;P = 0.14)和主要并发症发生率无显著差异。每组患者的平均吻合口数量相似。两组之间左内乳动脉的使用率无显著差异,尽管N组其他动脉移植物的使用率明显高于E组。两组中所有移植物的早期通畅率(98.5%对97.2%,P = 0.08)或1年通畅率(91.6%对89.3%,P = 0.28)均无显著差异。
老年患者CABG后的临床和血管造影结果与非老年患者几乎相同。