Department of Molecular and Clinical Medicine, Sahlgrenska Academy, Gothenburg University, Sweden.
Department of Molecular and Clinical Medicine, Sahlgrenska Academy, Gothenburg University, Sweden; Institute of Health and Care Sciences, Sahlgrenska Academy, Gothenburg University, Sweden.
Int J Cardiol. 2017 Oct 1;244:316-321. doi: 10.1016/j.ijcard.2017.05.013.
Updated knowledge about survival after coronary artery bypass graft (CABG) surgery is needed. We examined 20-year trends in 4-year survival after a first isolated CABG procedure, compared with that of the general population.
We identified 94,328 patients surviving 30days after a first isolated CABG 1987-2006 from the Swedish Inpatient Register.
Crude annual mortality rates remained stable at approximately 1% in patients aged 18-54years and at approximately 2% in those aged ≥55years. After adjustment for comorbidities, 4-year survival in men aged 18-54 and ≥55years improved by 37% (HR: 0.63, 95% CI, 0.46-0.88) and 31% (HR: 0.69, 95% CI, 0.63-0.76), respectively, (1987-1991 vs. 2002-2006). The corresponding estimate for women aged ≥55years was 38% (HR: 0.62, 95% CI, 0.52-0.75), with no significant change in survival in women aged <55years (HR: 1.02, 95% CI, 0.52-2.03). Men and women aged <55years had higher mortality than the general population, with standardized mortality ratios (SMR) of 1.76 (95% CI, 1.35-2.22) in men and 4.49 (95% CI, 2.74-6.68) in women during the last period (2002-2006). In contrast, patients aged ≥55years had better survival with a SMR of 0.74 (95% CI, 0.70-0.78) in men and 0.82 (95% CI, 0.74-0.91) in women during 2002-2006.
During 1987-2006, there was a significant improvement in survival after CABG for all categories, except in women aged <55years. Men and women aged ≥55years who survived the first 30days after CABG had a lower mortality risk than the general population.
需要更新关于冠状动脉旁路移植术（CABG）后生存的知识。我们研究了首例孤立性 CABG 术后 4 年生存率的 20 年趋势，并与普通人群进行了比较。
我们从瑞典住院患者登记处确定了 1987-2006 年间 30 天内幸存的 94328 例首次孤立性 CABG 患者。
18-54 岁和≥55 岁患者的粗年化死亡率在约 1%左右保持稳定，而在≥55 岁患者中则保持在约 2%左右。在调整了合并症后，18-54 岁和≥55 岁男性的 4 年生存率分别提高了 37%（HR：0.63，95%CI：0.46-0.88）和 31%（HR：0.69，95%CI：0.63-0.76）（1987-1991 年与 2002-2006 年相比）。≥55 岁女性的相应估计值为 38%（HR：0.62，95%CI：0.52-0.75），而<55 岁女性的生存率无明显变化（HR：1.02，95%CI：0.52-2.03）。<55 岁的男性和女性的死亡率均高于普通人群，标准化死亡率比（SMR）分别为 1.76（95%CI：1.35-2.22）和 4.49（95%CI：2.74-6.68），在最后一个时期（2002-2006 年）。相比之下，≥55 岁的患者的生存率更高，男性的 SMR 为 0.74（95%CI：0.70-0.78），女性的 SMR 为 0.82（95%CI：0.74-0.91）。
在 1987-2006 年期间，除了<55 岁的女性外，所有类别 CABG 后的生存率都有显著提高。首次 CABG 后存活 30 天的≥55 岁男性和女性的死亡率低于普通人群。
