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Thirty‐Day Mortality After Coronary Artery Bypass Surgery in Patients Aged <50 Years: Results of a Multicenter Study and Meta‐Analysis of the Literature
Author(s) -
D'Errigo Paola,
Biancari Fausto,
Maraschini Alice,
Rosato Stefano,
Badoni Gabriella,
Seccareccia Fulvia
Publication year - 2013
Publication title -
journal of cardiac surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.428
H-Index - 58
eISSN - 1540-8191
pISSN - 0886-0440
DOI - 10.1111/jocs.12091
Subject(s) - medicine , meta analysis , coronary artery bypass surgery , multicenter study , surgery , artery , coronary artery disease , cardiology , randomized controlled trial
Background Young patients requiring myocardial revascularization are considered at low operative risk, but data on their outcome are scarce. This study was undertaken to evaluate the prevalence and 30‐day mortality of patients aged <50 years after isolated coronary artery bypass surgery (CABG). Materials and methods This is a multicenter study including 2207 patients aged <50 years undergoing isolated CABG at 68 Italian hospitals. Results The proportion of patients aged <50 years in this series was 5.3% and varied significantly from 0% to 9.9% in different institutions (p < 0.0001). The 30‐day mortality rate was 0.9%. One‐to‐one propensity score matching of patients aged <50 years versus older patients resulted in 2013 pairs whose 30‐day mortality was 0.9% and 2.2%, respectively (p = 0.001). Logistic regression showed that left ventricular ejection fraction <30% (OR 5.5, 95% CI 1.6–18.6), peripheral vascular disease (OR 3.6, 95% CI 1.1–12.0), pulmonary hypertension (OR 18.1, 95% CI 1.8–187.0), critical preoperative state (OR 4.7, 95% CI 1.5–14.3), and emergency operation (OR 3.8, 95% CI 1.1–12.9) were independent predictors of 30‐day mortality. Meta‐analysis of five studies reporting on patients aged <50 years who underwent isolated CABG showed that operative mortality in these patients was 0.9% (95% CI, 0.8–1.1%, I 2 0%, 135/14,316 patients). Conclusions The proportion of patients aged <50 years undergoing CABG is low and varies significantly among institutions. The results of this study and a meta‐analysis of the literature data showed that CABG can be carried out in young patients with an extremely low risk of operative mortality. doi: 10.1111/jocs.12091 (J Card Surg 2013;28:207–211)