Carotid atherosclerosis is associated with in-hospital mortality after CABG Surgery

Abstract

Atherosclerosis is a widespread disease involving coronary and extra coronary arteries. Few data are reported about the association between degree of arterial involvement and in-hospital mortality rate in patients undergoing coronary artery bypass grafting (CABG). Aim of the present study was to evaluate whether carotid, femoral and abdominal aorta atherosclerosis, detected by ultrasound, is associated with in-hospital mortality in patients undergoing CABG. All patients undergoing coronary angiography and candidates to CABG, visited between January 1997 and November 1998 at the Institute of Cardiovascular Surgery of the Second University of Naples, underwent coronary heart disease (CHD) risk factors evaluation and complete echo-Doppler study. Out of 600 patients enrolled, 34 died before discharge. Both groups, survivors and deceased, were analyzed for studied variables. Hyperlipidemia was more prevalent among subjects who survived (30% vs. 18%, p <0.0001). Subjects who died were significantly older (64.1 ± 7.8 vs. 60.0 ± 9.4 years, mean ± SD, p <0.01), had higher prevalence of diabetes mellitus (56% vs. 29%, p <0.0008), carotid atherosclerosis (85% vs. 60%, p <0.003), left ventricular ejection fraction (EF) <40% (47% vs. 23%, p <0.001), and previous CABG surgery (5.8% vs. 1.2%, p <0.003). In multiple logistic regression analysis, only diabetes mellitus, EF <40%, and carotid atherosclerosis were significantly and independently associated with CABG outcome. The present findings demonstrate that echo-Doppler evaluation, at least of the carotid arteries, in addition to classical CHD risk factors, can help to predict the outcome after CABG surgery.