Læknablaðið - ágú. 2019, Blaðsíða 18

Thorkelsdottir T1
Johannesdottir H2
Arnadottir LO2
Adalsteinsson J6
Gardarsdottir HR3
Helgason D3
Axelsson TA2
Helgadottir S5
Heimisdottir A1
Sigurdsson MI,1,4
Gudbjartsson T1,2
Objectives: Our objective was to investigate long-term outcomes of
obese patients undergoing coronary artery bypass grafting (CABG) in
Iceland.
Materials and methods: A retrospective analysis on 1698 patients
that underwent isolated CABG in Iceland between 2001-2013. Pati-
ents were divided into four groups according to body mass index
(BMI); Normal=18.5-24.9kg/m2 (n=393), ii) overweight=25-29.9 kg/
m2 (n=811), iii) obese=30-34.9 kg/m2 (n=388) and iv) severely obese
≥35kg/m2 (n=113). Thirty-day mortality and short-term complications
were documented as well as long-term complications that were pooled
into major adverse cardiac and cerebrovascular events (MACCE) and
included myocardial infarction, stroke, repeated CABG, percutaneous
coronary intervention with or without stenting, and death. After pooling
the study groups, survival and freedom from MACCE plots (Kaplan-
Meier) were generated and Cox regression analysis used to identify
predictive factors of survival. Average follow-up time was 5.6 years.
Results: Severely obese and obese patients were significantly youn-
ger than those with a normal BMI, more often males with identifiable
risk factors of coronary artery disease (CAD) and a lower EuroSCORE
II (1.6 vs. 2.7, p=0.002). The incidence of major early complications,
30-day mortality (2%), long-term survival (90% at 5 years, log-rank
test p=0.088) and MACCE-free survival (81% at 5 years, log-rank test
p=0.7) was similar for obese and non-obese patients. BMI was neither
an independent predictor for long-term (OR: 0.98 95%-CI: 0.95-1.01)
nor MACCE-free survival (OR: 1.0 95%-CI: 0.98-1.02).
Conclusions: Obese patients that undergo CABG in Iceland are
younger and have an increased number of risk factors for coronary
disease when compared to non-obese patients. However, BMI neither
predicted long-term survival or long-term complications. The outcomes
following CABG in obese patients are good in Iceland.
No significant association between obesity and long-term outcome of coronary
artery bypass grafting
ENGLISH SUMMARY
1Faculty of Medicine, University of Iceland, Departments of 2Cardiothoracic Surgery, 3Internal Medicine and 4Anaesthesia and Intensive Care, Landspitali University Hospital,
5Department of Anaesthesia and Intensive Care, Akademiska University Hospital, Uppsala, Sweden. 6Department of Internal medicine and Dermatology,
University of Connecticut, Conneticut, USA
Key words: CABG, obesity, complications, long-term, MACCE, survival
Correspondence: Tómas Guðbjartsson tomasgudbjartsson@hotmail.com
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