Ten-Year Follow-up after Isolated Off-Pump CABG Depending on Syntax Score

Objectives: Aim of this retrospective study was to evaluate association between the high preoperative Syntax Score and mortality in isolated off-pump coronary bypass surgery (OPCAB) in long-term follow-up.

Methods: Consecutive 1805 patients undergoing primary isolated OPCAB from period of January 2005 to December 2014 were analyzed. Syntax Score was calculated and investigation groups were set as proposed by Syntax investigators. The influence of SYNTAX Score on in hospital and follow up mortality was evaluated.

Results: Total 1805 patients were included, 16.1% were females (n = 291) and mean age was 65.4 ± 9.9% years. Preoperative risk factors were as follows: diabetes mellitus in 28.1% (n = 507), peripheral vascular disease in 17.8% (n = 322), smokers were 36.8% (n = 665), COPD in 6.4% (n = 116), previous MI in 33% (695), significant LMS in 43% (n = 777). Preoperative mean Syntax Score was 31.4 ± 9. According to the three groups were identified: in low Syntax Score (0–22.5) were 17.1% (n = 308) cases, in intermediate score (23–32.5) 40.7% (n = 734) and high score (>33) were 42.3% (n = 763) of cases. Average of distal anastomosis was 3.72. In-hospital mortality was 1.4% (n = 26) and according to three groups it was: 0.16% in low (n = 3), 0.5% (n = 9) in intermediate and 0.77% (n = 14) in high Syntax group, p = 0.07. Mean follow up was 6.3 ± 2.9 years. Overall survival at 5 years was 92.3 ± 2.3% and at 10 years 84.3 ± 3.3%. Comparing groups of patients according to Syntax Score: Survival in low Syntax group at 93.6% 5-years and 84.8% at 10-years; in intermediate Group 91.2% at 5-years and 84.6% in 10-years; in high Syntax group 92.3% at 5-years and 83.5% in 10-years, p = 0.08. We analyzed follow-up Freedom of PCI: low Syntax 92.8%, intermediate Syntax 91.9% and high Syntax 89.8%, p = 0.07.

Conclusion: Complexity of coronary artery disease not associated with a higher incidence of in-hospital, long-term mortality or higher incidence of re PCI after primary off pump coronary artery bypass surgery underlying the superiority of CABG in these patients.

No conflict of interest has been declared by the author(s).