Multiple Arterial Grafting in Patients With Low Left Ventricular Ejection Fraction.

IF 3.7 3区医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

Circulation Journal Pub Date : 2025-07-25 Epub Date: 2025-04-18 DOI:10.1253/circj.CJ-24-1006

Kohei Hachiro, Noriyuki Takashima, Kenichi Kamiya, Masahide Enomoto, Yasuo Kondo, Fumihiro Miyashita, Hodaka Wakisaka, Tomoaki Suzuki

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引用次数: 0

Abstract

Background: This study compared postoperative outcomes in patients with a preoperative left ventricular ejection fraction (LVEF) of ≤35% who underwent multiple (MAG) or single (SAG) arterial grafting during off-pump isolated coronary artery bypass grafting.

Methods and results: Of 1,627 patients who underwent isolated coronary artery bypass grafting at Shiga University of Medical Science between 2002 and 2023, 176 with a preoperative LVEF ≤35% underwent MAG (n=115) or SAG (n=61). Baseline patient characteristics were comparable in the MAG and SAG groups after adjustment using inverse probability of treatment weighting. The study's mean (±SD) follow-up duration was 4.8±4.7 years. In the MAG and SAG groups, the adjusted estimated 5-year rates of freedom from all-cause death were 71.5% and 69.1%, respectively, while those of cardiac death were 94.1% and 89.5%, respectively. Kaplan-Meier curves showed significant differences in all-cause death (P=0.013) and cardiac death (P=0.001) favoring the MAG group. In a multivariable Cox hazards model, MAG was a predictor of all-cause death (hazard ratio 0.568; P=0.034) and cardiac death (hazard ratio 0.276; P=0.008).

Conclusions: Compared with SAG, MAG was associated with significantly lower rates of all-cause death and cardiac death.

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左室射血分数低患者的多动脉移植。

背景：本研究比较了术前左心室射血分数(LVEF)≤35%的患者在无泵离体冠状动脉旁路移植术中接受多路（MAG）或单路（SAG）动脉移植的术后结果。方法和结果：2002年至2023年间，在志贺医科大学接受孤立冠状动脉旁路移植术的1,627例患者中，术前LVEF≤35%的176例患者接受了MAG （n=115）或SAG （n=61）。在使用治疗加权逆概率调整后，MAG组和SAG组的基线患者特征具有可比性。该研究的平均（±SD）随访时间为4.8±4.7年。在MAG组和SAG组中，调整后的估计5年无全因死亡率分别为71.5%和69.1%，而心源性死亡分别为94.1%和89.5%。Kaplan-Meier曲线显示全因死亡（P=0.013）和心源性死亡（P=0.001）的显著差异有利于MAG组。在多变量Cox风险模型中，MAG是全因死亡的预测因子(风险比0.568；P=0.034)和心源性死亡(风险比0.276；P = 0.008)。结论：与SAG相比，MAG与较低的全因死亡率和心源性死亡率相关。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Circulation Journal 医学-心血管系统

CiteScore

5.80

自引率

12.10%

发文量

471

审稿时长

1.6 months

期刊介绍： Circulation publishes original research manuscripts, review articles, and other content related to cardiovascular health and disease, including observational studies, clinical trials, epidemiology, health services and outcomes studies, and advances in basic and translational research.