Long-term outcomes of coronary artery bypass grafting patients supported preoperatively with an intra-aortic balloon pump

ObjectiveMost studies describing the outcome of coronary artery bypass grafting patients supported preoperatively with an intra-aortic balloon pump (IABP) have reported early results. The purpose of our study was to evaluate the early and long-term results.MethodsOf 2658 isolated coronary artery bypass grafting procedures performed from 1996 to 2001, 215 were supported preoperatively with an IABP. The indications for IABP insertion were cardiogenic shock in 18 (8.4%), acute evolving myocardial infarction in 38 (17.7%), clinical instability in 84 (39.1%), and critical coronary lesions in 75 (34.9%).ResultsOperative mortality was 12.6%. The mortality of the cardiogenic shock patients was greater (22.2%; P = .174). Logistic regression analysis showed patient age (odds ratio, 1.057; 95% confidence interval, 1.010-1.108) and cardiopulmonary bypass (CPB) time (odds ratio, 1.020; 95% confidence interval, 1.008-1.031) were associated with increased operative mortality. An increased number of bypass grafts had a protective effect (odds ratio, 0.241; 95% confidence interval, 0.113-0.515). The actual early mortality was lower than the logistic EuroSCORE calculated mortality (12.6% vs 32.8%, P < .0001). The mean follow-up was 8 ± 4 years. The Kaplan-Meier 10-year survival was 49%. The Cox adjusted overall (early and late) survival and major adverse cardiac events-free survival of the different IABP subgroups was similar. Cox analyses showed peripheral vascular disease, off-pump coronary artery bypass surgery, age, CPB time, female gender, and fewer bypass grafts were associated with decreased survival.ConclusionsIn patients supported preoperatively with an IABP, better early and long-term results were strongly related to younger age, a shorter CPB time, and a greater number of bypass grafts. Avoiding the use of CPB (off pump) in these emergency cases is not recommended

Univariate Cox regression of additional factors that significantly affected 20-year survival of patients with chronic renal failure who underwent bilateral internal thoracic artery grafting.

Univariate Cox regression of additional factors that significantly affected 20-year survival of patients with chronic renal failure who underwent bilateral internal thoracic artery grafting.</p

Kaplan-Meier curve of survival for the unmatched cohort.

Kaplan-Meier curve of survival for the unmatched cohort.</p

Early outcomes of patients with chronic renal failure who underwent coronary artery bypass graft, according to matched and unmatched cohorts.

Early outcomes of patients with chronic renal failure who underwent coronary artery bypass graft, according to matched and unmatched cohorts.</p

Preoperative and intraoperative characteristics of patients with chronic renal failure who underwent coronary artery bypass graft, according to matched and unmatched cohorts.

Preoperative and intraoperative characteristics of patients with chronic renal failure who underwent coronary artery bypass graft, according to matched and unmatched cohorts.</p

Kaplan-Meier survival curves for each estimated glomerular ‎filtration rate group: eGFR≤15, 15>eGFR≤30, 3045 mL/min/1.73m2.

Kaplan-Meier survival curves for each estimated glomerular ‎filtration rate group: eGFR≤15, 15>eGFR≤30, 3045 mL/min/1.73m2.</p

Kaplan-Meier curve of survival for the matched cohort.

Kaplan-Meier curve of survival for the matched cohort.</p

Univariate and multivariable analysis for the association between the ‎surgical strategy (BITA vs. SITA) and patient survival.

Univariate and multivariable analysis for the association between the ‎surgical strategy (BITA vs. SITA) and patient survival.</p

STROBE statement—checklist of items that should be included in reports of observational studies—PONE-D-23-11606.

STROBE statement—checklist of items that should be included in reports of observational studies—PONE-D-23-11606.</p