Coronary Artery Bypass Grafting Feasible in Patients Over 80
Procedure extends long-term survival but carries surgical risks
TUESDAY, June 28, 2022 (HealthDay News) -- Coronary artery bypass grafting (CABG) may increase long-term survival even in elderly patients, according to a study published online June 20 in Mayo Clinical Proceedings.
Kukbin Choi, M.D., from the Mayo Clinic in Rochester, Minnesota, and colleagues assessed risks, outcomes, and trends in patients ≥80 years undergoing CABG. Analysis included 1,283 older, consecutive patients undergoing primary isolated CABG from Jan. 1, 1993, to Oct. 31, 2019, with a median follow-up of 16.7 years.
The researchers found that operative mortality was overall 4 percent but showed a significant decrease over the study period. Estimated survival rates were 90.2 percent at one year, 67.9 percent at five years, 31.1 at 10 years, and 8.2 percent at 15 years. Compared to age- and sex-matched octogenarians in the general U.S. population, median survival time was 6.0 and 7.6 years, respectively, with CABG. Significant risk factors of mortality included older age, recent atrial fibrillation or flutter, diabetes mellitus, smoking history, cerebrovascular disease, immunosuppressive status, extreme levels of creatinine, chronic lung disease, peripheral vascular disease, decreased ejection fraction, and increased Society of Thoracic Surgeons predicted risk score.
"Although CABG in octogenarians carries a higher surgical risk, it may be associated with favorable outcomes and increase in long-term survival," the authors write. "Further studies are warranted to define subgroups benefiting more from surgical revascularization."