Comparison of Isolated Primary CABG in Two Successive Decades in Patients Under 40 Years of Age

Heart Surg Forum. 2016 Jun 24;19(3):E139-44. doi: 10.1532/hsf.1448.

Abstract

Background: Coronary artery bypass graft (CABG) surgery is rarely performed in very young patients. The purpose of our study is to compare the characteristics, treatments, in-hospital, and long-term outcomes of two groups of patients less than 40 years of age who had CABG in two successive decades: 1990-2000 and 2001-2011.

Methods: We identified 145 consecutive patients who underwent primary isolated CABG. Group 1 consisted of 78 patients operated between 1990-2000 and group 2 consisted of 67 patients operated between 2001-2011. Composite end point assessed at follow-up period involved death or recurrence of symptoms, which we defined as myocardial infarction, a need for percutaneous coronary intervention (PCI), reoperation, or congestive heart failure (CHF).

Results: Smoking and hypercholesterolemia before CABG were noted as more frequent in group 1 than in group 2: 96.1% versus 83.6%, P = .011; 88.5% versus 61.2%, P = .0001, respectively. Patients from group 2 more frequently received one graft (29.8% versus 11.5%, P = .0059), were operated with off-pump (41.8% versus 0%, P < .0001) or MIDCAB (28.4% versus 0%, P = .0008) techniques, and had complete arterial revascularization (58.2% versus 23.1%, P < .0001). Group 1 patients had a higher prevalence of composite end point (33.9% versus 17.9%, P = .035), with no significant difference in mortality (11.5% versus 10.4%, P = .83).

Conclusion: Patients operated between 1990-2000 had a higher prevalence of smoking and hypercholesterolemia and higher frequency of composite-end point during folow-up period without significant difference in mortality.

Publication types

  • Comparative Study

MeSH terms

  • Adult
  • Age Factors
  • Coronary Artery Bypass*
  • Coronary Artery Disease / etiology
  • Coronary Artery Disease / surgery*
  • Follow-Up Studies
  • Humans
  • Hypercholesterolemia / complications
  • Reoperation
  • Risk Factors
  • Smoking / adverse effects
  • Treatment Outcome
  • Young Adult