Coronary artery bypass grafting for elderly with unprotected left main coronary artery disease: a clinical analysis

Abstract

Objective To study the correlation between the clinical features and the prognosis in elderly patients with unprotected left main coronary artery disease(ULMCA)after cornary artery bypass grafting(CABG).Methods The clinical parameters and prognosis data from 176 patients received CABG for ULM were retrospectively analyzed for comparison of elderly(age≥65)anagainst non-elderly(age＜65).Results The elderly patients were found to have significantly higher level of blood high density lipoprotein cholesterin(HDL-C,mmol/L:28.36± 17.20 vs.13.68± 7.78,P＜0.01),lower level of blood low density lipoprotein cholesterin(LDL-C,mmol/L:1.21 ± 0.77 vs.2.48 ± 1.27,P＜ 0.01)and higher level of coronary stenosis[(94.56 ± 8.01)％ vs.(87.96 ± 11.10)％,p ＜ 0.01].The incidence of multi-vessel disease(75.9％ vs.58.1％,P＜0.05)and chronic total occlusion(55.4％ vs.29.0％,P＜0.05)were both significantly higher in the elderly.No significant difference was found between the two groups in major adverse cardiac and cerebral events(MACCE),cerebral infarction,myocardial infarction,cardiac mortality,and total mortality(16.9％ vs 17.2％,3.6％ vs 3.2％,3.6％ vs 5.4％,6.0％ vs 9.7％,and 12.0％ vs 8.6％,all P＞0.05).Conclusion In the elderly ULMCA patients the coronary lesions are more severe,but CABG is still a safe and efficient therapy for these patients. Key words: Unprotected left main coronary artery disease ; Coronary artery bypass grafting ; Elderly ;