Symptomatic peripheral artery disease is associated with decreased long-term survival after coronary artery bypass: a contemporary retrospective analysis

Abstract

Little has been documented about whether the severity of peripheral artery disease (PAD) affects the postoperative outcomes of coronary artery bypass grafting (CABG). We performed a retrospective analysis of 683 patients who underwent isolated CABG, comparing preoperative profiles and postoperative outcomes between patients with PAD (n=116) and those without PAD (n=567). Kaplan-Meier analysis was done to examine the long-term survival and the Cox proportional hazard model was used to establish the preoperative risk factors associated with survival. The PAD patients were older and had more preoperative comorbidities than those without PAD. There were three operative deaths in each group (p=0.07). The patients with PAD had more postoperative complications related to transfusion requirement (p=0.004), the need for re-exploration for bleeding (p=0.04), longer ventilation time (p<0.001), and longer ICU stay (p=0.001), than those without PAD. The 10-year survival rate of the PAD patients was lower than that of the non-PAD patients (p<0.001). Univariate and multivariate analyses revealed that symptomatic PAD (p=0.008) was associated with decreased long-term survival. Symptomatic PAD was found to be an independent factor for poor long-term survival after CABG. Thus, aggressive screening measures for coronary disease, early surgical revascularization, and secondary prevention may improve the early and long-term outcomes of these patients.