Medical University of Vienna, Vienna, Austria.
Royal Prince Alfred Hospital.
Int J Surg. 2023 Apr 1;109(4):707-715. doi: 10.1097/JS9.0000000000000259.
The objective of the European Multicenter Registry to Assess Outcomes in coronary artery bypass grafting (CABG) patients (DuraGraft Registry) was to determine clinical outcomes and quality of life (QoL) after contemporary CABG that included isolated CABG and combined CABG/valve procedures, using an endothelial damage inhibitor (DuraGraft) intraoperatively for conduit preservation. Here, we report outcomes in the patient cohort undergoing isolated CABG.
The primary outcome was the composite of all-cause death, myocardial infarction (MI), or repeat revascularization (RR) [major adverse cardiac events (MACE)] at 1 year. Secondary outcomes included the composite of all-cause death, MI, RR, or stroke [major adverse cardiac and cerebrovascular events (MACCE)], and QoL. QoL was assessed with the EuroQol-5 Dimension questionnaire. Independent risk factors for MACE at 1 year were determined using Cox regression analysis.
A total of 2532 patients (mean age, 67.4±9.2 years; 82.5% male) underwent isolated CABG. The median EuroScore II was 1.4 [interquartile range (IQR), 0.9-2.3]. MACE and MACCE rates at 1 year were 6.6% and 7.8%, respectively. The rates of all-cause death, MI, RR, and stroke were 4.4, 2.0, 2.2, and 1.9%, respectively. The 30-day mortality rate was 2.3%. Age, extracardiac arteriopathy, left ventricular ejection fraction less than 50%, critical operative state, and left main disease were independent risk factors for MACE. QoL index values improved from 0.84 [IQR, 0.72-0.92] at baseline to 0.92 [IQR, 0.82-1.00] at 1 year ( P <0.0001).
Contemporary European patients undergoing isolated CABG have a low 1-year clinical event rate and an improved QoL.
评估冠状动脉旁路移植术（CABG）患者结局的欧洲多中心登记处（DuraGraft 登记处）旨在确定包括单纯 CABG 和 CABG/瓣膜手术联合手术在内的当代 CABG 后的临床结局和生活质量（QoL），术中使用内皮损伤抑制剂（DuraGraft）来保存移植物。此处，我们报告了接受单纯 CABG 的患者队列的结局。
主要结局是 1 年时全因死亡、心肌梗死（MI）或再次血运重建（RR）[主要不良心脏事件（MACE）]的复合结局。次要结局包括全因死亡、MI、RR 或中风[主要不良心脏和脑血管事件（MACCE）]以及 QoL 的复合结局。使用 EuroQol-5 维度问卷评估 QoL。使用 Cox 回归分析确定 1 年时 MACE 的独立危险因素。
共 2532 例患者（平均年龄 67.4±9.2 岁，82.5%为男性）接受了单纯 CABG。EuroScore II 中位数为 1.4 [四分位距（IQR），0.9-2.3]。1 年时 MACE 和 MACCE 发生率分别为 6.6%和 7.8%。全因死亡率、MI、RR 和中风发生率分别为 4.4%、2.0%、2.2%和 1.9%。30 天死亡率为 2.3%。年龄、心脏外动脉疾病、左心室射血分数<50%、危急手术状态和左主干疾病是 MACE 的独立危险因素。QoL 指数值从基线时的 0.84 [IQR，0.72-0.92]改善至 1 年时的 0.92 [IQR，0.82-1.00]（P<0.0001）。
接受单纯 CABG 的当代欧洲患者 1 年临床事件发生率低，生活质量提高。
