Table 1.
Baseline and intra-operative characteristics of patients with ejection fraction ≤40 % who underwent cardiac surgery: comparisons between survivors and dead patients
| Variable | Total (N = 781) | Survivors (N = 737) | Dead (N = 44) | P-value |
|---|---|---|---|---|
| Preoperative characteristics | ||||
| Gender (Male), n | 597 (76 %) | 569 (77 %) | 28 (64 %) | 0.04 |
| Age, years | 65.4 ± 10.3 | 65.3 ± 10.4 | 68.4 ± 9.4 | 0.0575 |
| Height, cm | 169.6 ± 8.1 | 169.7 ± 8.0 | 167.6 ± 9.4 | 0.2 |
| Weight, kg | 73.7 ± 13.4 | 73.8 ± 13.3 | 71.2 ± 14.6 | 0.2 |
| BMI | 25.6 ± 4.0 | 25.6 ± 4.0 | 25.4 ± 4.4 | 0.8 |
| Comorbidity | ||||
| > COPD, n | 235 (30 %) | 210 (28 %) | 25 (57 %) | <0.001 |
| > Preoperative EF, % | 33.9 ± 6.1 | 34.0 ± 6.1 | 31.8 ± 6.0 | 0.01 |
| > Preoperative EF ≤ 40 %, n | 781 (100 %) | |||
| > Preoperative EF ≤ 30 %, n | 290 (37 %) | |||
| > Peripheral vasculopathy, n | 196 (25 %) | 183 (25 %) | 13 (30 %) | 0.5 |
| > Arterial hypertension, n | 423 (54 %) | 402 (55 %) | 21 (48 %) | 0.4 |
| > Type II diabetes mellitus, n | 159 (20 %) | 151 (20 %) | 8 (18 %) | 0.7 |
| > Carotid stenosis, n | 71 (9.1 %) | 68 (9.2 %) | 3 (6.8 %) | 0.8 |
| > Angina, n | 112 (14 %) | 104 (14 %) | 8 (18 %) | 0.5 |
| > Previous AMI, n | 243 (31 %) | 227 (31 %) | 16 (36 %) | 0.4 |
| > Previous TIA or stroke, n | 61 (7.8 %) | 58 (7.9 %) | 3 (6.8 %) | 0.99 |
| > Previous vascular surgery, n | 37 (4.7 %) | 37 (5 %) | 0 (0 %) | 0.3 |
| > Standard EuroSCORE | 6 (4–8) | 6 (4–8) | 8 (6–10) | <0.001 |
| > ACEF score | 2.08 (1.77–2.47) | 2.06 (1.75–2.44) | 2.43 (2.08–3.16) | <0.001 |
| > ACEF risk | 5.59 (3.89–8.78) | 5.46 (3.81–8.56) | 8.45 (5.61–18.52) | <0.001 |
| > Endocarditis, n | 22 (2.8 %) | 20 (2.7 %) | 2 (4.5) | 0.4 |
| > Creatinine clearance, ml/h | 65.1 (49.2–82.6) | 65.67 (50.23–83.33) | 49.1 (39.66–69.27) | 0.002 |
| > Chronic renal failure, n | 149 (19 %) | 134 (18 %) | 15 (34 %) | 0.009 |
| > Dialysis, n | 13 (1.7 %) | 12 (1.6 %) | 1 (2.3 %) | 0.5 |
| NYHA | 0.003 | |||
| > I | 51 (6.5 %) | 51 (6.9 %) | 0 (0 %) | |
| > II | 208 (27 %) | 201 (27 %) | 7 (16 %) | |
| > III | 276 (35 %) | 267 (36 %) | 9 (20 %) | |
| > IV | 43 (5.5 %) | 36 (4.9 %) | 7 (16 %) | |
| Timing of surgery | 0.2 | |||
| > Emergency, n | 18 (2.3 %) | 16 (2.2 %) | 2 (4.5 %) | |
| > Urgency, n | 129 (17 %) | 119 (16 %) | 10 (23 %) | |
| > Election, n | 634 (81 %) | 602 (82 %) | 32 (73 %) | |
| Redo surgery, n | 81 (10 %) | 73 (9.9 %) | 8 (18 %) | 0.08 |
| Preoperative IABP, n | 135 (17 %) | 121 (16 %) | 14 (32 %) | 0.009 |
| Preoperative inotropes, n | 17 (2.2 %) | 11 (1.5 %) | 6 (14 %) | <0.001 |
| Chronic therapy | ||||
| > Antiplatelets, n | 267 (34 %) | 258 (35 %) | 9 (20 %) | 0.048 |
| > Diuretics, n | 503 (64 %) | 470 (64 %) | 33 (75 %) | 0.13 |
| > Beta-blockers, n | 365 (47 %) | 353 (48 %) | 12 (27 %) | 0.008 |
| > Antibiotics, n | 38 (4.9 %) | 34 (4.6 %) | 4 (9.1 %) | 0.16 |
| > Calcium channel blockers, n | 128 (16 %) | 121 (16 %) | 7 (16 %) | 0.9 |
| > Nitrates, n | 217 (28 %) | 205 (28 %) | 12 (27 %) | 0.9 |
| > ACE inhibitors, n | 496 (64 %) | 473 (64 %) | 23 (52 %) | 0.11 |
| > Oral anticoagulants, n | 135 (17 %) | 130 (18 %) | 5 (11 %) | 0.4 |
| > Heparin, n | 61 (7.8 %) | 57 (7.7 %) | 4 (9.1 %) | 0.8 |
| Creatinine, mg/dl | 1.2 ± 0.9 | 1.2 ± 0.9 | 1.5 ± 1.1 | 0.004 |
| Bilirubin, mg/dl | 0.8 (0.57–1.1) | 0.8 (0.57–1.04) | 0.94 (0.63–1.4) | 0.1 |
| Surgical interventions | ||||
| CABG, n | 390 (31 %) | 373 (31 %) | 17 (23 %) | 0.12 |
| > Isolated CABG, n | 189 (15 %) | 185 (16 %) | 4 (5.4 %) | 0.02 |
| Mitral valve surgery, n | 282 (22 %) | 258 (22 %) | 24 (32 %) | 0.009 |
| > Isolated mitral valve surgery, n | 90 (7.1 %) | 84 (7.1 %) | 6 (8.1 %) | 0.7 |
| > Mitral valve replacement, n | 126 (10 %) | 117 (9.9 %) | 9 (12 %) | 0.4 |
| > Mitral valve repair, n | 156 (12 %) | 141 (12 %) | 15 (20 %) | 0.02 |
| Aortic valve surgery, n | 241 (19 %) | 227 (19 %) | 14 (19 %) | 0.9 |
| > Isolated aortic valve surgery, n | 81 (6.4 %) | 76 (6.4 %) | 5 (6.8 %) | 0.8 |
| > Aortic valve replacement, n | 241 (19 %) | 227 (19 %) | 14 (19 %) | 0.9 |
| > Aortic valve repair, n | 1 (0.08 %) | 1 (0.08 %) | 0 (0 %) | 0.99 |
| Tricuspid valve surgery, n | 96 (7.6 %) | 91 (7.7 %) | 5 (6.8 %) | 0.99 |
| > Isolated tricuspid valve surgery, n | 3 (0.24 %) | 3 (0.25 %) | 0 (0 %) | 0.99 |
| > Tricuspid valve replacement, n | 6 (0.48 %) | 6 (0.51 %) | 0 (0 %) | 0.99 |
| > Tricuspid valve repair, n | 90 (7.1 %) | 85 (7.2 %) | 5 (6.8 %) | 0.99 |
| Pulmonic valve surgery, n | 1 (0.08 %) | 1 (0.08 %) | 0 (0 %) | 0.99 |
| > Isolated pulmonic valve surgery, n | 1 (0.08 %) | 1 (0.08 %) | 0 (0 %) | 0.99 |
| Surgery on ascending aorta, n | 83 (6.6 %) | 76 (6.4 %) | 7 (9.5 %) | 0.2 |
| > Isolated surgery on ascending aorta, n | 6 (0.48 %) | 6 (0.51 %) | 0 (0 %) | 0.99 |
| Left ventricle surgery, n | 77 (6.1 %) | 76 (6.4 %) | 1 (1.4 %) | 0.11 |
| > Isolated left ventricle surgery, n | 12 (0.95 %) | 12 (1 %) | 0 (0 %) | 0.99 |
| Intraoperative management | ||||
| CPB, n | 696 (91 %) | 656 (89 %) | 40 (91 %) | 0.4 |
| Duration of aortic cross clamping, min | 61 (48–78) | 61 (47–78) | 69.5 (51–78) | 0.3 |
| Duration of CPB, min | 85 (65–102) | 84 (65–101) | 95 (70–114) | 0.3 |
ACEF age-creatinine-ejection fraction, AMI acute myocardial infarction, BMI body mass index, CABG coronary artery bypass graft, COPD chronic obstructive pulmonary disease, CPB cardiopulmonary bypass, EF ejection fraction, IABP intra-aortic balloon pump, NYHA New York Heart Association, TIA transient ischemic attack