Articles

Coronary Artery Bypass Surgery versus Medical Treatment in Patients with Low Ejection Fraction and Coronary Artery Disease

Abstract

Background: We compared the outcomes in patients with a low ejection fraction (EF) and multivessel coronary artery disease (CAD) who either underwent coronary artery bypass grafting (CABG) or received medical treatment (MT) after a viability study via dobutamine stress echocardiography (DSE).

Methods: We considered patients with CAD and left ventricular ejection fraction (LVEF) <40% who were referred for DSE, and enrolled 106 patients (89% male, mean age: 55.8±9.7 years) with ≥4 viable segments. According to DSE, all the 106 patients were suitable for revascularization. We compared the outcomes between the patients who underwent CABG and those who received MT at a mean follow-up time of 8 months.

Results: Both groups had similar baseline characteristics and rest EF. Thirty-three (31.1%) patients underwent CABG and 73 (68.9%) received MT. There was no significant difference between the CABG and MT groups in terms of mortality rate (9.1% vs. 11.0 %) and improvement in New York Heart Association functional class at follow-up. In the CABG group, patients with LVEF ≤25% had higher mortality compared to patients with LVEF >25% (100% vs. 40%, P< 0.05).

Conclusion: The patients with CAD and a low EF had the same survival rate after both CABG and MT at mid-term follow-up. Long-term follow-up is needed to show the survival benefit of CABG in such patients with an acceptable extent of viable myocardium. 

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IssueVol 3 No 3 (2008): J Teh Univ Heart Ctr QRcode
SectionArticles
 
Keywords
Stress echocardiography Coronary artery bypass Heart failure

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Creative Commons License This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
How to Cite
1.
Sadeghian H, Salarifar M, Karimi AA, Marzban M, Abbasi K, Lotfi-Tokaldany M, Sheikhfathollahi M, Majd M, Jahangiri S, Abbasi SH. Coronary Artery Bypass Surgery versus Medical Treatment in Patients with Low Ejection Fraction and Coronary Artery Disease. J Tehran Heart Cent. 3(3):145-150.