Five-year mortality of patients with perioperative myocardial infarction after on-pump isolated or combined coronary artery bypass graft surgery: A retrospective propensity score-weighted analysis

• Published in: Archives of cardiovascular diseases Vol. 117; no. 1; pp. S25 - S26
• Main Authors: Beyls, C., Huette, P., Huang, P., Kowalik, H., Andreamifidi-Berti, C., Guilbart, M., Bernasinsiki, M., Besserve, P., Touati, G., Caus, T., Dupont, H., Mahjoub, Y., Arab, Abou O.
• Format: Journal Article
• Language: English
• Published: Elsevier/French Society of Cardiology 01.01.2024
• Subjects: Human health and pathology; Life Sciences
• ISSN: 1875-2136; 1875-2128
• DOI: 10.1016/j.acvd.2023.10.044

IntroductionCoronary artery bypass grafting (CABG) is a common surgery for coronary artery disease in isolated or combined cardiac surgical procedures. Perioperative myocardial infarction (pMI) increases mortality in isolated on-pump CABG. However, the incidence and prognosis of pMI are contingent upon the specific universal definition (UD) of myocardial infarction employed, with no available data currently reported for combined procedures.ObjectiveThe study aimed to assess the association between pMI and the 5-year mortality in patients undergoing isolated or combined on-pump CABG.MethodWe included in this retrospective study adult patients undergoing elective or urgent on-pump isolated or combined CABG in the Amiens University Hospital during the 2013–2017 period. pMI was defined according to the 4th UD of myocardial infarction. The primary outcome was 5-year mortality, defined as all-cause death after cardiac surgery. Multivariable regression was performed to assess the association between pMI and 5-year mortality. Inverse probability weighting (IPW) derived from propensity scores was used to reduce imbalances in baseline and intra operative characteristics.ResultsFrom January 2013 to January 2017, 712 patients were included and assessed. 112 (16%) patients developed pMI. The 5-year mortality rate was significantly higher in the pMI group (respectively for pMI, 34% vs11%; P < 0.001). Active smoking (P = 0.001) and a cardiopulmonary bypass time > 180 min (P = 0.01) were associated with pMI. In a multivariable model, pMI was an independent predictor factor of 5-year mortality (OR = 2.48, 95% confidence interval (95%CI) = [1.60–3.87], P < 0.001). After IPW (Graph1), pMI remained significantly associated with 5-year mortality (OR = 1.15; 95%CI [1.13–1.16]; P < 0.001).ConclusionpMI was a frequent complication of isolated or combined CABG procedures and was an independent factor of 5 years of mortality.