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Carr et al. Vessel Plus 2020;4:12 Vessel Plus
DOI: 10.20517/2574-1209.2020.01

Original Article Open Access

Risk factors adversely impacting post coronary

artery bypass grafting longer-term vs. shorter-term
clinical outcomes

Brendan M. Carr , Frederick L. Grover , Annie Laurie W. Shroyer 3,4
2
1
1 Department of Emergency Medicine, Mayo Clinic, Rochester, MN 55905, USA.
2 Department of Surgery, University of Colorado, School of Medicine, Anschutz Medical Campus, Aurora, CO 80045, USA.
3 Department of Surgery, Stony Brook University, School of Medicine, Stony Brook, NY 11794, USA.
4 Departmenf of Surgery, Northport Veterans Affairs Medical Center, Northport, NY 11768, USA.

Correspondence to: Dr. Annie Laurie W. Shroyer, Tenured Professor and Vice Chair for Research, Department of Surgery, Stony
Brook University School of Medicine, Health Sciences Center Level 19, Room #083, 100 Nicolls Road, Stony Brook, New York,
NY 11794-8191, USA. E-mail: annielaurie.shroyer@stonybrookmedicine.edu

How to cite this article: Carr BM, Grover FL, Shroyer ALW. Risk factors adversely impacting post coronary artery bypass grafting
longer-term vs. shorter-term clinical outcomes. Vessel Plus 2020;4:12. http://dx.doi.org/10.20517/2574-1209.2020.01

Received: 2 Jan 2020 First Decision: 4 Feb 2020 Revised: 21 Feb 2020 Accepted: 9 Mar 2020 Published: 11 May 2020
Science Editor: Mario F. L. Gaudino Copy Editor: Jing-Wen Zhang Production Editor: Tian Zhang

Abstract
Aim: Coronary artery bypass grafting (CABG) patients’ characteristics and surgical techniques associated with short-
term (ST; < 1 year) mortality are well documented; however, the literature pinpointing factors predictive of longer-term (LT;
≥ 1 year) death rates are more limited. Thus, the CABG factors associated with ST vs. LT mortality were compared.
Methods: Using advanced PubMed search techniques, the factors associated with improved post-CABG mortality were
compared for ST vs. LT prediction models; ST vs. LT models’ results were compared across three time periods: until
1997, 1998-2007, and 2007-2017.
Results: Of 156 post-CABG mortality risk models (n = 125 publications), 133 ST and 23 LT models were evaluated.
Important predictors consistently included age, ejection fraction, and renal dysfunction/dialysis. The ST models more
commonly identified surgical priority, gender, and prior cardiac surgery; however, the LT models more frequently
included diabetes and peripheral arterial disease. Compared to ST mortality, patterns also emerged for cerebrovascular
disease and chronic lung disease predicting LT mortality. As modifiable risks, body mass index or another marker of
body habitus appeared in 31/133 (23%) of ST models; smoking or tobacco use was considered in only 4/133 (3%). No
models evaluated compliance with ischemic heart disease guidelines. No time period-related differences were found.

Conclusion: Different risk factors predicted ST vs. LT post-CABG mortality; for LT death, debilitating chronic/complex
comorbidities were more often reported. As few models focused on identifying modifiable patient risks or ischemic heart
disease guideline compliance, future CABG LT risk modeling should address these knowledge gaps.

© The Author(s) 2020. Open Access This article is licensed under a Creative Commons Attribution 4.0
International License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use,
sharing, adaptation, distribution and reproduction in any medium or format, for any purpose, even commercially, as long
as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license,
and indicate if changes were made.

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