Outcomes of coronary artery bypass grafting in elderly patients: A comprehensive analysis of different surgical approaches (from the KROK Registry)
Year: 2025
Type: article
Study design: Observational Study
Abstract: BACKGROUND: Coronary artery revascularization is vital for managing coronary artery disease, especially in elderly patients with multiple comorbidities. AIMS: To evaluate the outcomes of coronary artery bypass surgery in patients aged ≥75 years, focusing on the survival benefits of different surgical techniques and graft types. MATERIAL AND METHODS: This retrospective cohort study analyzed data from the Polish National Registry of Cardiac Surgery Procedures (2012-2022) for patients aged ≥75 years undergoing isolated coronary artery bypass surgery. RESULTS: We analysed 18 215 patients: 12 843 patients were under 80 years old; 4689 were between 80 and 84 years old; and 683 were ≥85 years old. Key preoperative risk factors associated with increased hospital mortality included extracardiac arteriopathy, atrial fibrillation, chronic renal failure, recent myocardial infarction, and poor mobility. The median follow-up time was 4.8 years (interquartile range 2.37-7.27). On-pump coronary artery bypass grafting (ONCAB) demonstrated a significant long-term benefit in patients aged <80 years. The use of an internal mammary artery graft provided significant survival advantages for those <85 years old, but this benefit was not observed in patients aged ≥85 years (P = 0.73). Multiarterial grafting did not demonstrate a significant survival advantage across all age groups. CONCLUSIONS: In patients ≥80 years old there was no survival benefit between ONCAB and off-pump coronary bypass grafting. However, ONCAB was associated with significantly improved survival outcomes in younger patients. The internal mammary artery graft improved long-term survival in patients <85 years old, while additional arterial grafts did not confer a survival benefit in the elderly population.
Source: Kardiologia Polska
Authors: Kinga Kosiorowska, Tomasz Hrapkowicz, Marek Jasiński, Roman Przybylski, Marek Deja, Jan Rogowski, Witold Gerber, Jerzy Pacholewicz, Romuald Cichoń, Marek Cisowski, Wojciech Pawliszak, Paweł Bugajski, Michał Krejca, Tomasz Hirnle, Bartłomiej Perek, Zdzisław Tobota, Bohdan Maruszewski, And KROK Investigators
Institutions: Wroclaw Medical University, Medical University of Silesia, University of Wrocław, Silesian Center for Heart Disease, Gdańsk Medical University, American Heart of Poland, Pomeranian Medical University, University of Opole, Nicolaus Copernicus University, Collegium Medicum in Bydgoszcz, Medical University of Lodz, Medical University of Białystok, Poznan University of Medical Sciences, Children's Memorial Health Institute
Language: English
Subfield: Surgery
Field: Medicine
Domain: Health Sciences
Open Access status: diamond
OpenAlex ID: W4408884370