[Jiangsu province coronary artery bypass grafting registry study: a report of 7 475 patients from 16 centers].

Abstract

Objective: To evaluate coronary artery bypass grafting (CABG) in Jiangsu Provinc registry database from 2019 to 2024. Methods: This is a multicenter retrospective registry study. Data of the CABG registry database in Jiangsu Province from January 2019 to December 2024 were retrospectively collected. A total of 7 475 patients who underwent isolated CABG from 16 medical centers. There were 5 484 males and 1 991 females, with an age of (66.7±9.2) years (range: 23 to 92 years) and a body mass index of (24.6±3.2) kg/m² (range:15.5 to 39.6 kg/m²).Preoperative risk factors, medical history, cardiac function were analyzed (New York Heart Association classification), coronary artery disease, European Heart Surgery Risk Assessment System Ⅱ(EuroSCORE Ⅱ) score, whether CPB was used, whether arterial bridge was used, the number and flow of bridge vessels, postoperative stroke, myocardial infarction and mediastinal infection were analyzed. Independent sample t-test and χ² test were used to compare the differences in clinical data between patients undergoing on-pump coronary artery bypass grafting (ONCABG) and off-pump coronary artery bypass grafting (OPCAB). Results: Left main coronary artery disease was present in 2 181 cases (29.18%), three-vessel disease in 6 212 cases (83.10%), and left main coronary artery disease combined with three-vessel disease in 1 987 cases (26.58%). Left ventricular ejection fraction (LVEF)<50% was observed in 1 544 cases (20.66%), cardiac function class Ⅲ to Ⅳ in 2 654 cases (35.51%), and the EuroSCORE Ⅱ score was (M(IQR)) 1.28% (1.87%) (range: 0.8% to 39.4%). There were a total of 5 214 cases of ONCABG (69.75%) and 2 261 cases of OPCAB (30.25%). The left internal mammary artery (LIMA) was used in 6 407 cases (85.71%), with skeletonized LIMA in 2 949 cases (46.03%) and pedicled LIMA in 3 458 cases (53.97%). Sixteen centers used the radial artery as conduit material. The number of grafts per patient was 3.1±1.1 (range:1 to 7). The intraoperative cardiopulmonary bypass time was (106.0±34.9) min (range:22 to 310 min), and the aortic cross-clamp time was (76.9±26.2) min (range:20 to 205 min). There were 168 in-hospital deaths (2.25%). Reoperations in 110 cases (1.47%), including 86 cases of re-sternotomy for hemostasis and 24 cases of repeat revascularization. Perioperative complications: myocardial infarction 36 cases (0.48%), stroke 73 cases (0.98%), 274 cases of acute kidney injury after operation (3.67%), 100 cases (1.34%) of renal failure requiring dialysis 134 cases (1.79%) of mediastinal infection 6 450 cases were discharged for secondary prevention compared with OPCAB group, ONCABG group had a higher proportion of patients with smoking history, higher proportion of patients with hyperlipidemia, chronic lung disease, carotid artery stenosis, cardiac function Ⅲ to Ⅳ, history of Percutaneous Coronary Intervention higher EuroSCORE Ⅱ score, more left main trunk with three vessels disease, lower LVEF, higher proportion of intraoperative red suspension infusion; Postoperative acute kidney injury, new renal failure dialysis, secondary thoracotomy, stroke, poor incision healing, and in-hospital mortality were all increased (all P<0.05). Conclusions: CABG registry database in Jiangsu Province generally operated well from 2019 to 2024. Compared with OPCAB group, ONCABG group patients had more severe preoperative conditions, higher postoperative complications and in-hospital mortality. Overall perioperative complications in Jiangsu Province were controlled close to or better than international advanced levels.