Aim
The aim was to use a propensity score-based analysis to determine the impact of peripheral
artery disease (PAD) on early outcomes after coronary artery bypass surgery grafting
(CABG) in patients with PAD.
Method
We conducted a multicentre retrospective analysis of 11,311 consecutive patients who
underwent CABG between 1997 and 2017. Patients with previous or concomitant vascular
surgery were excluded. The main endpoints were death, stroke, and limb ischaemia requiring
percutaneous or surgical revascularisation. Subgroup analyses were performed to test
the interaction of PAD with concomitant factors.
Results
There was no difference in mortality in patients with and without PAD (p=0.06 and
p=0.179, respectively). Patients with PAD had a greater incidence of stroke (p=0.04),
acute kidney disease (p=0.003), and limb ischaemia requiring interventions (p<0.001)
than those without PAD. The use of off-pump or no-touch aortic techniques did not
influence the effect of PAD on the outcomes. Early mortality rate increased in patients
with PAD when associated with long cardiopulmonary bypass, cross-clamp times (both
p<0.001), and postoperative low cardiac output (p=0.01).
Conclusions
The presence of PAD is associated, independently of other factors, with greater incidence
of stroke, acute kidney disease, and limb ischaemia following CABG, irrespective of
the technique employed. Operative mortality was greater in patients with PAD only
when associated with long cardiopulmonary bypass and aortic cross-clamp times, and
low cardiac output.
Keywords
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Article Info
Publication History
Published online: February 20, 2020
Accepted:
January 11,
2020
Received in revised form:
December 14,
2019
Received:
May 31,
2019
Identification
Copyright
© 2020 Australian and New Zealand Society of Cardiac and Thoracic Surgeons (ANZSCTS) and the Cardiac Society of Australia and New Zealand (CSANZ). Published by Elsevier B.V. All rights reserved.
