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Trends in mortality risks among 94,328 patients surviving 30 days after a first isolated coronary artery bypass graft procedure from 1987 to 2006: A population-based study

Journal article
Authors Susanne Nielsen
Lena Björck
Anders Jeppsson
Kok Wai Giang
Kristin Falk
Sylvia Määttä
Tatiana Zverkova Sandström
Annika Rosengren
Published in International Journal of Cardiology
Volume 244
Pages 316-321
ISSN 0167-5273
Publication year 2017
Published at Institute of Health and Care Sciences
Institute of Medicine, Department of Molecular and Clinical Medicine
Pages 316-321
Language en
Links dx.doi.org/10.1016/j.ijcard.2017.05...
Keywords Coronary artery bypass graft surgery, Coronary artery disease, Survival, Temporal trends, acute myocardial-infarction, surgery, women, revascularization, outcomes, disease, men, database, sweden, cohort, Cardiovascular System & Cardiology, ahle e, 1994, european heart journal, v15, p1204
Subject categories Clinical Medicine

Abstract

Background: Updated knowledge about survival after coronary artery bypass graft (CABG) surgery is needed. We examined 20-year trends in 4-year survival after a first isolated CABG procedure, compared with that of the general population. Methods: We identified 94,328 patients surviving 30 days after a first isolated CABG 1987-2006 from the Swedish Inpatient Register. Results: Crude annual mortality rates remained stable at approximately 1% in patients aged 18-54 years and at approximately 2% in those aged >= 55 years. After adjustment for comorbidities, 4-year survival in men aged 18-54 and >= 55 years improved by 37% (HR: 0.63, 95% CI, 0.46-0.88) and 31% (HR: 0.69, 95% CI, 0.63-0.76), respectively, (1987-1991 vs. 2002-2006). The corresponding estimate for women aged >= 55 years was 38% (HR: 0.62, 95% CI, 0.52-0.75), with no significant change in survival in women aged b55 years (HR: 1.02, 95% CI, 0.52-2.03). Men and women aged b55 years had higher mortality than the general population, with standardized mortality ratios (SMR) of 1.76 (95% CI, 1.35-2.22) in men and 4.49 (95% CI, 2.74-6.68) in women during the last period (2002-2006). In contrast, patients aged >= 55 years had better survival with a SMR of 0.74 (95% CI, 0.70-0.78) in men and 0.82 (95% CI, 0.74-0.91) in women during 2002-2006. Conclusion: During 1987-2006, there was a significant improvement in survival after CABG for all categories, except in women aged < 55 years. Men and women aged >= 55 years who survived the first 30 days after CABG had a lower mortality risk than the general population.

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