Does Age at Operation Influence the Short- and Long-Term Outcomes of Off-Pump Coronary Artery Bypass Grafting?

ABSTRACT

BACKGROUND: To investigate the relationship between age and both short- and long-term outcomes of off-pump coronary bypass grafting (OPCAB). METHODS AND RESULTS: The 780 patients undergoing OPCAB were divided into 3 groups 262 aged <65 years (young), 329 aged 65-74 years (early elderly), and 189 aged >75 years (late elderly), and retrospectively analyzed. The follow-up rate was 94.9%, and mean follow-up period was 5.6±3.4 years. In-hospital mortality rates were similar among the groups (0.8% in young, 1.2% in early elderly, and 1.1% in late elderly; P=0.862). In logistic regression analysis, the risk factor for predicting major complications was the New York Heart Association (NYHA) classification (odds ratio 1.555, P=0.001), and not age. The 10-year estimated rates free from cardiac death (89.6±3.2, 95.0±2.1, and 96.5±2.1%, log rank, P=0.16) and cardiac events (71.8±3.8, 66.8±4.3, and 59.9±7.7%, P=0.61) were not significantly different among the groups. In multivariate Cox models, independent risk factors predicting cardiac events were the NYHA classification (hazard ratio (HR) 1.265, P=0.009), and ejection fraction (HR 0.986, P=0.016), but not age (young HR 1.0, early elderly HR 1.276; P=0.210, late elderly HR 0.910; P=0.707). CONCLUSIONS: Both short- and long-term cardiac outcomes of OPCAB are not influenced by age at operation.