Incidence and trends of heart failure admissions after coronary artery bypass grafting surgery
Open Access
- 27 January 2013
- journal article
- research article
- Published by Wiley in European Journal of Heart Failure
- Vol. 15 (1), 46-53
- https://doi.org/10.1093/eurjhf/hfs154
Abstract
Aims Factors related to hospitalization for heart failure (HF) following coronary artery bypass grafting (CABG) surgery were studied. Methods and results Patients (n = 65 377) undergoing CABG surgery in New Jersey from 1998 to 2007 were identified from the state cardiac surgery database; subsequent hospitalizations for HF were assessed using the Myocardial Infarction Data Acquisition System database. Patients were classified based on pre‐operative ejection fraction (EF). Multivariate models were used to identify factors related to HF admission and mortality. Post‐CABG HF admission rates among patients with pre‐operative EF P = 0.02), but no significant trend was seen among patients with EF ≥35%. Independent factors associated with post‐CABG HF admission within 2 years were: EF, age, female gender, Black race, smoking, diabetes, renal disease, hypertension, and cerebrovascular disease. Pre‐operative use of beta‐blockers increased over the years (P < 0.0001) and reduced the risk of admission for HF by 13%, with greater benefit in patients with lower EF. Mortality remained unchanged from 1998 to 2007, averaging 1.8% in‐hospital and 5.1% and 7.2% at 1‐year and 2‐year follow‐up, respectively. Conclusions Pre‐operative EF is a strong predictor of HF admission within 2 years after CABG surgery. The use of beta‐blockers decreased HF admission after CABG, especially in patients with EF <35%. Despite the more pronounced benefit and increasing use of beta‐blockers in patients with a low EF, HF admission rates in this group of patients are rising. This suggests that more comprehensive management of factors associated with HF is necessary.This publication has 21 references indexed in Scilit:
- Revascularization among patients with severe left ventricular dysfunction: a meta‐analysis of observational studiesEuropean Journal of Heart Failure, 2011
- Record linkage software in the public domain: a comparison of Link Plus, The Link King, and a `basic' deterministic algorithmHealth Informatics Journal, 2008
- Effects of Angiotensin-Converting Enzyme Inhibition in Low-Risk Patients Early After Coronary Artery Bypass SurgeryCirculation, 2008
- Weekend versus Weekday Admission and Mortality from Myocardial InfarctionThe New England Journal of Medicine, 2007
- Angiotensin-Converting–Enzyme Inhibition in Stable Coronary Artery DiseaseThe New England Journal of Medicine, 2004
- Effects of quinapril on clinical outcome after coronary artery bypass grafting (the QUO VADIS study)The American Journal of Cardiology, 2001
- Drug Therapy Before Coronary Artery SurgeryAnesthesia & Analgesia, 1999
- Beta-blocker effects on postoperative atrial fibrillationEuropean Journal of Cardio-Thoracic Surgery, 1997
- Sex differences in the management and long-term outcome of acute myocardial infarction. A statewide study. MIDAS Study Group. Myocardial Infarction Data Acquisition System.Circulation, 1994
- Coronary artery bypass in patients with severely depressed ventricular functionThe Annals of Thoracic Surgery, 1993