Abstract
Background Coronary artery bypass grafting (CABG) is frequently performed in patients with end-stage
renal disease (ESRD) together with severe coronary artery disease, after which, patients
with ESRD have higher surgical risk and poorer long-term outcomes. We report our experience
in patients with ESRD who survived in CABG and identify predictors of long-term outcomes.
Methods We retrospectively investigated 93 consecutive patients with ESRD who survived to
discharge after isolated CABG between January 2005 and December 2016 at our institution.
Long-term outcomes, including all-cause mortality after discharge, readmission due
to major adverse cardiac events, and reintervention, were evaluated. Predictors affecting
long-term outcomes were also analyzed.
Results The rates of freedom from all-cause mortality after discharge in 1, 3, 5, and 10
years were 92.1, 81.3, 71.9, and 34.9%, respectively. The rates of freedom from readmission
due to major adverse cardiac events in 1, 3, 5, and 10 years were 90.7, 79.1, 69.9,
and 55.6%, respectively. The rates of freedom from reintervention in 1, 3, 5, and
10 years were 95.3, 86.5, 79.0, and 66.6%, respectively. Postoperative β-blocker and
statin use significantly improved overall long-term survival (β-blocker, p = 0.013; statin, p = 0.009). After case–control matching, patients who received statins showed better
long-term survival than those without statins. The comparison of long-term survival
between patients with and without β-blockers showed no significant difference after
matching.
Conclusions After CABG, dialysis patients who survived to discharge had acceptable long-term
overall survival. Post-CABG statin use in dialysis patients is a predictor of better
long-term survival.
Keywords
coronary artery bypass grafts surgery - CABG - ischemic heart disease - angina
