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Ann Thorac Surg 1998;65:377-382
© 1998 The Society of Thoracic Surgeons

Original Articles: Cardiovascular

Late Outcome of Coronary Artery Bypass Grafting in Young Versus Older Patients

Isabella Rohrer-Gubler, MD, Urs Niederhauser, MD, Marko I. Turina, MD

Division of Cardiovascular Surgery, Department of Surgery, University Hospital, Zurich, Switzerland

Accepted for publication July 17, 1997.

Dr Rohrer-Gubler, Sprecherstrasse 5, 8032 Zurich, Switzerland.

Background. We compared long-term results of coronary artery bypass grafting between 1976 and 1988 in 176 patients 40 years old or younger with a matched control group of 176 patients 25 to 30 years older.

Methods. Mean age was 37.4 ± 2.7 years (± standard deviation) in the study group and 64.2 ± 2.9 years in the control group. Matching criteria were age, sex, left ventricular ejection fraction, number of bypass grafts, and year of operation.

Results. The study group had more smokers (p = 0.000) and more patients with hypercholesterolemia (p = 0.026), unstable angina (p = 0.003), and preoperative myocardial infarction (p = 0.009); fewer patients had hypertension (p = 0.000) and diabetes (p = 0.005) in this group than in the control group. The internal mammary artery was used in 31% of the study patients and in 30% of the controls. The actuarial survival rates after 5, 10, and 15 years were 92%, 86%, and 72% in the study group and 92%, 86%, and 66% in the control group (p = 0.202). Young age was a predictor of cardiac reoperation.

Conclusions. Late survival is similar for young and older patients, but the reintervention rate is higher in the younger group. The absence of unstable angina, a left ventricular ejection fraction greater than 0.45, and the use of internal mammary artery grafts increase survival in all patients.






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