Baseline characteristics and 1-year outcome by left ventricular function in the CABG PREFERS.

Abstract

Aims: The aim of this study is to describe patients undergoing elective coronary artery bypass grafting (CABG) surgery by left ventricular (LV) function at baseline and 1-year follow-up.

Methods and results: In the single-centre CABG PREFERS cohort prospective study, we classified patients planned for elective CABG by LV function assessed by echocardiography and N-terminal pro-B-type natriuretic peptide (NT-proBNP) into three phenotype groups: preserved ejection fraction (EF; pEF), reduced EF (rEF), and normal, irrespective of signs or symptoms of heart failure (HF). At baseline and 1-year follow-up, electrocardiogram, echocardiography, cardiac magnetic resonance imaging, laboratory tests, and quality of life were assessed. Sixty-one of a total of 136 patients (45%) had systolic and/or diastolic LV dysfunction (25% pEF, 20% rEF, and the rest 55% none: the normal group). Median EF was 59% (pEF), 40% (rEF), and 59% (normal). Most patients had multivessel coronary artery disease without left main stem stenosis (60%). At 1-year follow-up, some improvements in echo parameters were seen in pEF and rEF. But in the normal group compared to baseline, there were deteriorations in the following: E/é: 7.8-8.9, P < 0.001; NT-proBNP 150-182 ng/L, P = 0.015; and estimated glomerular filtration rate (eGFR) 82.5-78.9 mL/min/1.73 m², P = 0.003. During a median follow-up time of 2.9 years, eight patients (5.8%) died and eight (5.8%) were hospitalized for HF.

Conclusion: In patients undergoing elective CABG, signs of LV dysfunction were common and found in 45%. Patients with normal LV function showed signs of worsening systolic and diastolic LV function, eGFR, and NT-pro-BNP at 1-year follow-up.

Registration: Clinicaltrials.gov identifier: NCT03671122.