open access

Vol 66, No 12 (2008)
Other
Published online: 2009-01-07
Submitted: 2012-12-28
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Original article
Predictors of long-term outcome in patients with left ventricular dysfunction following coronary artery bypass grafting

Anna Rybicka-Musialik, Krzysztof Szydło, Krystian Wita, Artur Filipecki, Witold Orszulak, Zbigniew Tabor, Anna-Maria Wnuk-Wojnar, Maria Trusz-Gluza, Michał Krejca, Andrzej Bochenek
Kardiol Pol 2008;66(12):1261-1266.

open access

Vol 66, No 12 (2008)
Other
Published online: 2009-01-07
Submitted: 2012-12-28

Abstract

Background: Prognostic significance of clinical and non-invasive risk markers in patients after surgical revascularisation remains unclear, especially in post-infarction patients with left ventricular (LV) dysfunction. Aim: The single-centre, prospective study was designed to assess survival and the predictive power of several clinical and non- -invasive risk markers of all-cause (ACM) and cardiovascular mortality (CVM) in post-CABG patients with LV dysfunction. Methods: A cohort of 61 patients (age 59±9 years, 49 males, LVEF 33±6%) 6-12 months after CABG was prospectively followed for a median of 46 months. Demographics, clinical data, medication, LVEF, QRS>120 ms or late potentials (LP) presence, QT dispersion ł80 ms, premature ventricular contractions (PVC) ł10/h, non-sustained ventricular tachycardia (nsVT), and SDNN Ł70 ms in ambulatory ECG were analysed. The ACM and CVM were evaluated. The prognostic value of analysing parameters was determined. Results: Fourteen patients died, 10 of them due to cardiovascular causes. Univariate Cox analysis showed that incomplete revascularisation, history of angina, heart failure, low LVEF, use of nitrates, digitalis or diuretics, and presence of LP or prolongation of QRS complex were predictors of poor outcome. Combination of angina and low LVEF was the best model in a multivariable Cox analysies for the prediction of both types of death. Conclusions: The present study showed that in post-CABG patients with LV dysfunction, angina class and low LVEF are the main predictors of ACM and CVM. Combination of LVEF <30% with the presence of QRS >120 ms or LP may also be helpful in the identification of high-risk subjects. Other common non-invasive risk markers, particularly arrhythmic and autonomic, seem to lose some of their predictive power in patients after CABG and receiving beta-blocking agents.

Abstract

Background: Prognostic significance of clinical and non-invasive risk markers in patients after surgical revascularisation remains unclear, especially in post-infarction patients with left ventricular (LV) dysfunction. Aim: The single-centre, prospective study was designed to assess survival and the predictive power of several clinical and non- -invasive risk markers of all-cause (ACM) and cardiovascular mortality (CVM) in post-CABG patients with LV dysfunction. Methods: A cohort of 61 patients (age 59±9 years, 49 males, LVEF 33±6%) 6-12 months after CABG was prospectively followed for a median of 46 months. Demographics, clinical data, medication, LVEF, QRS>120 ms or late potentials (LP) presence, QT dispersion ł80 ms, premature ventricular contractions (PVC) ł10/h, non-sustained ventricular tachycardia (nsVT), and SDNN Ł70 ms in ambulatory ECG were analysed. The ACM and CVM were evaluated. The prognostic value of analysing parameters was determined. Results: Fourteen patients died, 10 of them due to cardiovascular causes. Univariate Cox analysis showed that incomplete revascularisation, history of angina, heart failure, low LVEF, use of nitrates, digitalis or diuretics, and presence of LP or prolongation of QRS complex were predictors of poor outcome. Combination of angina and low LVEF was the best model in a multivariable Cox analysies for the prediction of both types of death. Conclusions: The present study showed that in post-CABG patients with LV dysfunction, angina class and low LVEF are the main predictors of ACM and CVM. Combination of LVEF <30% with the presence of QRS >120 ms or LP may also be helpful in the identification of high-risk subjects. Other common non-invasive risk markers, particularly arrhythmic and autonomic, seem to lose some of their predictive power in patients after CABG and receiving beta-blocking agents.
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Keywords

left ventricular dysfunction; heart failure; CABG; survival; risk factors

About this article
Title

Original article
Predictors of long-term outcome in patients with left ventricular dysfunction following coronary artery bypass grafting

Journal

Kardiologia Polska (Polish Heart Journal)

Issue

Vol 66, No 12 (2008)

Pages

1261-1266

Published online

2009-01-07

Bibliographic record

Kardiol Pol 2008;66(12):1261-1266.

Keywords

left ventricular dysfunction
heart failure
CABG
survival
risk factors

Authors

Anna Rybicka-Musialik
Krzysztof Szydło
Krystian Wita
Artur Filipecki
Witold Orszulak
Zbigniew Tabor
Anna-Maria Wnuk-Wojnar
Maria Trusz-Gluza
Michał Krejca
Andrzej Bochenek

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