Observational studyBMC cardiovascular disorders2025
Optimal medical therapy in patients with reduced left ejection fraction undergoing coronary artery bypass graft surgery.
Observational study in BMC cardiovascular disorders, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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5 authors.
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Abstract
backgroundOur aim was to explore clinical outcomes between patients with- and without of optimal medical therapy (OMT) in patients with reduced left ventricular ejection fraction (LVEF) undergoing coronary artery bypass graft surgery (CABG).
methodsIn this single-centre observational study, all patients who underwent isolated CABG with a preoperative LVEF of ≤ 40% between 2012 and 2021 were included. Individual data were collected from the medical health records and the register Carath. OMT was defined as prescription of renin-angiotensin-aldosterone system inhibitor (RAAS-I), beta-blocker (BB), Acetylsalicylic acid (ASA) and statins.
results102 patients were identified. The frequency of patients with OMT was 44% at admission and 67% 72%, 69% and 68% at discharge, 2 months, 1 year and 2 years follow-up. Patients with OMT at discharge had a significant longer median time to the composite endpoint of first-time hospitalization and all-cause mortality compared to the No-OMT group (1.7 versus 7.1 years, log rank p = 0.0038). OMT at discharge was associated with a lower adjusted risk of all-cause mortality and first-time hospitalization for heart failure (adjusted hazard ratio, 0.25; 95% confidence interval, 0.11-0.58; p = < 0.001).
conclusionsThe prescription rate of OMT increased until the 2 months follow-up with no further increases in dose at 1 year and 2 years follow-up. Patients undergoing CABG with a preoperative reduced left ventricular ejection fraction that were prescribed OMT at discharge had better outcomes in terms of a reduced risk of hospitalization for heart failure and all-cause mortality.
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