Comparison of Two-Year Outcomes in Patients Undergoing Isolated Coronary Artery Bypass Grafting With and Without Peripheral Artery Disease

• Published in: The American journal of cardiology Vol. 104; no. 10; pp. 1377 - 1382
• Main Authors: Popovic, Batric, MD, Arnould, Marc Antoine, MD, Selton-Suty, Christine, MD, Latarche, Clotilde, MD, Angioi, Michael, MD, PhD, Carteaux, Jean Pierre, MD, PhD, Villemot, Jean Pierre, MD, Aliot, Etienne, MD
• Format: Journal Article
• Language: English
• Published: New York, NY Elsevier Inc 15.11.2009; Elsevier; Elsevier Limited
• Subjects: Age Factors; Aged; Atherosclerosis - mortality; Biological and medical sciences; Cardiology; Cardiology. Vascular system; Cardiovascular; Cardiovascular disease; Clinical outcomes; Comparative studies; Coronary Artery Bypass; Coronary Artery Disease - mortality; Coronary Artery Disease - therapy; Coronary heart disease; Erythrocyte Transfusion - utilization; Female; Follow-Up Studies; France - epidemiology; Heart; Heart surgery; Humans; Hypertension - epidemiology; Kidney Diseases - epidemiology; Lung Diseases - epidemiology; Male; Medical sciences; Middle Aged; Myocardial Infarction - epidemiology; Patients; Sex Factors; Stroke - epidemiology; Stroke Volume; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Surgery of the heart; Surgical Wound Infection - epidemiology; Survival analysis; Survival Rate; France; Human; Prognosis; Disease; Coronary artery bypass; Cardiovascular disease; Patient; Circulatory system; Cardiology; Coronary heart disease; In vitro; Artery; Comparative study
• ISSN: 0002-9149; 1879-1913
• DOI: 10.1016/j.amjcard.2009.07.001

We aimed to evaluate the long-term clinical outcomes among patients with peripheral arterial disease (PAD) after coronary artery bypass grafting. We studied 589 consecutive patients who had undergone isolated coronary artery bypass grafting from January 2003 to June 2005 at our university hospital. The effect of PAD was assessed by comparing the 2-year follow-up data from 2 groups of patients: 243 patients with and 346 without PAD. A large systematic atherosclerosis screening was performed, including cerebrovascular disease, lower extremity artery disease, and abdominal aorta disease and its branches. PAD was defined as a history of treated atherosclerotic disease and significant atherosclerotic stenosis on screening. Patients with PAD were significantly older (70 ± 9 vs 64 ± 11 years, p <0.001) and were more often men (p = 0.04) than those without PAD. They had a greater incidence of hypertension (p = 0.002), chronic renal dysfunction (p <0.01), chronic pulmonary disease (p = 0.005), and a history of coronary artery disease (p = 0.03). No significant difference was noted between the 2 groups with regard to the left ventricular ejection fraction. The 2-year cumulative survival rate was 76.6% for patients with PAD and 94.1% for those with isolated coronary disease (p <0.001). In conclusion, after adjusting all significant variables, the presence of PAD appeared as an independent predictive factor for all-cause mortality (adjusted hazard ratio 3.2, 95% confidence interval 1.8 to 5.7, p = 0.001).