Korean J Thorac Cardiovasc Surg.  2019 Jun;52(3):155-161. 10.5090/kjtcs.2019.52.3.155.

Comparison of Off-Pump Coronary Artery Bypass between Octogenarians and Septuagenarians: A Propensity Score Analysis

Affiliations
  • 1Department of Thoracic and Cardiovascular Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea. wooksung.kim@samsung.com
  • 2Department of Thoracic and Cardiovascular Surgery, Sejong General Hospital, Bucheon, Korea.

Abstract

BACKGROUND
Coronary artery bypass grafting (CABG) is being offered increasingly frequently to octogenarians. However, old age is known to be an independent risk factor in CABG. The aim of this study was to compare the outcomes of off-pump coronary artery bypass (OPCAB) between octogenarians and septuagenarians.
METHODS
We retrospectively reviewed the data of 1,289 consecutive patients aged ≥70 years who underwent OPCAB at a single institution between 2001 and 2016. We compared the outcomes of 115 octogenarians and 1,174 septuagenarians. Using propensity score matching, based on preoperative clinical characteristics, 114 octogenarians were matched with 338 septuagenarians.
RESULTS
Propensity score analysis revealed that the incidence of acute kidney injury (14.9% vs. 7.9%, p=0.028) and respiratory complications (8.8% vs. 4.2%, p=0.040) was significantly higher in octogenarians. The early mortality rate (2.6% vs. 1.0%, p=0.240) and 1-year survival rate (89.5% vs. 94.4%, p=0.097) were not statistically significant between the groups. However, the 5-year survival rate (67.3% vs. 79.9%, p<0.001) was significantly lower in octogenarians. Previous myocardial infarction and a left ventricular ejection fraction ≤35% were associated with a poor 1-year survival rate.
CONCLUSION
Early and 1-year outcomes of OPCAB in octogenarians were tolerable when compared with those in septuagenarians. OPCAB could be a suitable option for octogenarians.

Keyword

Coronary artery bypass grafting; Off-pump coronary artery bypass; Aged

MeSH Terms

Acute Kidney Injury
Aged, 80 and over*
Coronary Artery Bypass
Coronary Artery Bypass, Off-Pump*
Humans
Incidence
Mortality
Myocardial Infarction
Propensity Score*
Retrospective Studies
Risk Factors
Stroke Volume
Survival Rate
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