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Sabzi, Feridoun, Karim, Hossein, Chaghazardi, Shahrokh, Asadmobini, Atefeh. (1395). Comparison of Treatment Outcomes in Off-pump Coronary Artery Bypass Graft and Medical Therapy in Patients with Triple-vessel Coronary Artery Disease and Severe Ventricular Dysfunction. , 4(2), 450-455. doi: 10.22038/jctm.2016.6959
Feridoun Sabzi; Hossein Karim; Shahrokh Chaghazardi; Atefeh Asadmobini. "Comparison of Treatment Outcomes in Off-pump Coronary Artery Bypass Graft and Medical Therapy in Patients with Triple-vessel Coronary Artery Disease and Severe Ventricular Dysfunction". , 4, 2, 1395, 450-455. doi: 10.22038/jctm.2016.6959
Sabzi, Feridoun, Karim, Hossein, Chaghazardi, Shahrokh, Asadmobini, Atefeh. (1395). 'Comparison of Treatment Outcomes in Off-pump Coronary Artery Bypass Graft and Medical Therapy in Patients with Triple-vessel Coronary Artery Disease and Severe Ventricular Dysfunction', , 4(2), pp. 450-455. doi: 10.22038/jctm.2016.6959
Sabzi, Feridoun, Karim, Hossein, Chaghazardi, Shahrokh, Asadmobini, Atefeh. Comparison of Treatment Outcomes in Off-pump Coronary Artery Bypass Graft and Medical Therapy in Patients with Triple-vessel Coronary Artery Disease and Severe Ventricular Dysfunction. , 1395; 4(2): 450-455. doi: 10.22038/jctm.2016.6959

Comparison of Treatment Outcomes in Off-pump Coronary Artery Bypass Graft and Medical Therapy in Patients with Triple-vessel Coronary Artery Disease and Severe Ventricular Dysfunction

Journal of Cardio-Thoracic Medicine
مقاله 5، دوره 4، شماره 2، شهریور 2016، صفحه 450-455    اصل مقاله (1.02 M)
نوع مقاله: Original Article
شناسه دیجیتال (DOI): 10.22038/jctm.2016.6959
نویسندگان
Feridoun Sabzi1؛ Hossein Karim2؛ Shahrokh Chaghazardi2؛ Atefeh Asadmobini* 3
1Cardiac Surgean, Cardiovascular Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran
2Cardiologist, Cardiovascular Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran
3MSc of Cardiac Physiology, Cardiovascular Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran
چکیده
Introduction: Heart failure is a major hazard for public health. Despite recent advance in medical therapy, there is not enough information on the outcome of off-pump coronary artery bypass (OPCAB) and medical therapy on the patients with severe ventricular dysfunction and triple-vessel (CAD). This study aimed to compare treatment outcomes and mortality rate in patients undergoing off-pump coronary artery bypass (OPCAB) surgery and medical therapy who presented with severe ventricular dysfunction and triple-vessel coronary artery disease (CAD).
Materials and Methods: This retrospective cohort study was conducted on patients with severe ventricular dysfunction and triple-vessel CAD during 2010-2011 in the Imam Ali Hospital of Kermanshah University of Medical Science. Patients were divided into two groups of medical therapy (group one) and OPCAB (group two). Follow-up data were collected after 30 months. Survival estimation was performed using Kaplan-Meier survival analysis and Cox regression model.
Results: Of the 276 enrolled patients, 139(50.4%) underwent group one and 137(49.6%) group two. Study groups were homogenous in baseline characteristics, with the exception of hyperlipidemia (P=0.005). A significant difference was observed in cardiac mortality rates between the study groups (hazard ratio: 0.260; 95% confidence interval: 0.105-0.644; P=0.004). However, no significant difference was observed between the groups regarding the frequency of admission due to decompensate heart failure (P=0.17). In addition, the rate of admission due to acute coronary syndrome (ACS) in the first group was higher than the second group, significantly (P=0.001). Level of ejection fraction (EF) had a significant increase after coronary artery bypass graft (CABG) (28.50) compared to the preoperative stage (27.59) (P=0.042). However, no significant increase in the level of EF was observed in the first group before and after medical therapy (27.28 and 27.20, respectively) (P=0.83).
Conclusion: According to the results of this study, the mortality rate associated with OPCAB was lower compared to medical therapy, ACS and EF enhancement in patients with triple-vessel CAD and severe ventricular dysfunction.
کلیدواژه‌ها
Coronary Artery Disease؛ Medical Therapy؛ Off-Pump Coronary Artery Bypass Graft
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