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ORIGINAL RESEARCH article

Front. Cardiovasc. Med.
Sec. Cardiovascular Surgery
Volume 11 - 2024 | doi: 10.3389/fcvm.2024.1513149
This article is part of the Research Topic Surgical Revascularization of the Ischemic Myocardium in the third millennium View all articles

Outcomes and Risk Factors Associated with In-Hospital Mortality in Patients Undergoing Coronary Artery Bypass Grafting with Low Ejection Fraction

Provisionally accepted
Yang Zhao Yang Zhao 1Xu Yu Xu Yu 1*Xiaolong Ma Xiaolong Ma 2*Liang Zhang Liang Zhang 1*
  • 1 Anhui Chest Hospital, Hefei, China
  • 2 Beijing Anzhen Hospital, Capital Medical University, Chaoyang District, Beijing, China

The final, formatted version of the article will be published soon.

    Objective: To investigate the short-term prognosis and risk factors associated with in-hospital mortality in patients undergoing coronary artery bypass grafting (CABG) with low ejection fraction. Methods: Clinical data were collected from 765 patients who underwent CABG with an ejection fraction of less than 40% between 2019 and 2023 at Anhui Chest Hospital and Beijing Anzhen Hospital, Capital Medical University. The patients were categorized into a in-hospital mortality group (n=38) and a in-hospital survival group (n=727), based on whether they died within 30 days post-operation. Univariate and multivariate logistic regression analyses were employed to identify risk factors for in-hospital mortality. The relationship between these risk factors and the likelihood of in-hospital mortality was assessed using restricted cubic splines (RCS). Additionally, predictive values were evaluated by plotting receiver operating characteristic curves (ROC). Results: In-hospital mortality occurred in 38 out of the 765 patients, resulting in an incidence rate of 4.97%. Compared to the survival group, those in the mortality group exhibited significantly higher rates of exploratory thoracotomy, intra-aortic balloon pump usage, extracorporeal membrane oxygenation application, gastrointestinal bleeding incidents, and acute renal failure occurrences. Independent risk factors for in-hospital mortality included preoperative age, left ventricular ejection fraction (LVEF), fasting glucose levels (Glu), and glomerular filtration rate (eGFR). Conversely, standardized preoperative administration of oral nitrates and aspirin as well as intraoperative utilization of internal mammary arteries emerged as protective factors against in-hospital mortality. ROC analysis revealed predictive efficiencies for age at 68.5%, LVEF at 76.6%, Glu at 60.5%, while eGFR demonstrated a predictive efficiency of approximately 78.1%. Conclusion: The incidence of in-hospital mortality in patients undergoing coronary artery bypass grafting with low ejection fraction is correlated with several factors, including advanced age, LVEF, Glu, eGFR, and the standardized preoperative administration of oral nitrates and aspirin. These findings serve as a guide for enhancing the in-hospital prognosis for this patient population in clinical practice.

    Keywords: coronary artery bypass grafting, Cardiac insufficiency, In-hospital mortality, Risk factors, LVEF

    Received: 17 Oct 2024; Accepted: 30 Dec 2024.

    Copyright: © 2024 Zhao, Yu, Ma and Zhang. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence:
    Xu Yu, Anhui Chest Hospital, Hefei, China
    Xiaolong Ma, Beijing Anzhen Hospital, Capital Medical University, Chaoyang District, 100029, Beijing, China
    Liang Zhang, Anhui Chest Hospital, Hefei, China

    Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.