Department of Cardiovascular Surgery, Tokyo Women's Medical University Hospital, 8-1, Kawada-cho, Shinjuku, Tokyo, Japan.
Heart Vessels. 2024 Feb;39(2):175-184. doi: 10.1007/s00380-023-02317-x. Epub 2023 Sep 25.
Little is known regarding the long-term (> 10 years) outcomes and risk factors of total arterial coronary artery bypass grafting (CABG). This study evaluated the long-term outcomes and risk factors for all-cause mortality and major adverse cardiac and cerebrovascular events (MACCEs) following total arterial on-pump CABG (ONCAB) or off-pump CABG (OPCAB) with complete revascularization. This retrospective cohort analysis enrolled patients with stable angina who underwent total arterial CABG with complete revascularization in our institute between July 2000 and June 2019. The endpoints were all-cause mortality and MACCE incidence, including a comparison between OPCAB and ONCAB. Long-term (10-year) outcomes were analyzed using propensity score-matched pairs, and risk factors were evaluated using univariate and multivariate analyses. Overall, 401 patients who underwent primary total arterial CABG were classified into the OPCAB (n = 269) and ONCAB (n = 132) groups. Using propensity score matching (PSM), 88 patients who underwent OPCAB were matched with 88 patients who underwent ONCAB. The mean follow-up period was 7.9 ± 6.3 years. No significant difference in all-cause mortality (hazard ratio, 1.04; 95% confidence interval, 0.53-2.04; p = 0.9138) and MACCE incidence (hazard ratio, 1.06; 95% confidence interval, 0.68-1.65; p = 0.7901) was observed between the two groups. Renal failure requiring dialysis was a significant risk factor for mortality (p < 0.0001) and MACCEs (p = 0.0003). Long-term outcomes of total arterial OPCAB and ONCAB with complete revascularization showed similar findings using PSM. Renal failure requiring dialysis was a significant risk factor for mortality and morbidity.Journal standard instruction requires an unstructured abstract; hence the headings provided in abstract were deleted. Kindly check and confirm.Thank you for your kindness.Clinical registration number 5598, Tokyo Women's Medical University Hospital.
关于全动脉冠状动脉旁路移植术（CABG）的长期（>10 年）结果和危险因素知之甚少。本研究评估了在我院接受完全血运重建的全动脉体外循环 CABG（ONCAB）或非体外循环 CABG（OPCAB）后全因死亡率和主要心脏和脑血管不良事件（MACCE）的长期结果和危险因素。本回顾性队列分析纳入了 2000 年 7 月至 2019 年 6 月期间在我院接受完全血运重建的稳定型心绞痛患者。终点是全因死亡率和 MACCE 发生率，包括 OPCAB 和 ONCAB 之间的比较。使用倾向评分匹配对进行长期（10 年）结果分析，并使用单变量和多变量分析评估危险因素。共有 401 例患者接受了原发性全动脉 CABG，分为 OPCAB（n=269）和 ONCAB（n=132）组。使用倾向评分匹配（PSM），将 88 例接受 OPCAB 的患者与 88 例接受 ONCAB 的患者进行匹配。平均随访时间为 7.9±6.3 年。两组之间全因死亡率（危险比，1.04；95%置信区间，0.53-2.04；p=0.9138）和 MACCE 发生率（危险比，1.06；95%置信区间，0.68-1.65；p=0.7901）无显著差异。需要透析的肾衰竭是死亡（p<0.0001）和 MACCE（p=0.0003）的显著危险因素。使用 PSM，完全血运重建的全动脉 OPCAB 和 ONCAB 的长期结果显示出相似的发现。需要透析的肾衰竭是死亡和发病率的显著危险因素。
临床注册号 5598，东京女子医科大学医院。
