CABG and Preoperative use of Beta-Blockers in Patients with Stable Angina are Associated with Better Cardiovascular Survival

Abstract Objective: In contrast to unstable angina, optimal therapy in patients with stable angina is debated. Our aim was to evaluate the outcomes of patients with stable angina scheduled for isolated coronary artery bypass grafts and the effect of preoperative use of beta-blockers. Overall and ca...

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Main Authors: Victor Dayan, Diego Perez, Eloisa Silva, Gerardo Soca, Jorge Estigarribia
Format: Article
Language:English
Published: Sociedade Brasileira de Cirurgia Cardiovascular
Series:Brazilian Journal of Cardiovascular Surgery
Subjects:
Online Access:http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0102-76382018000100047&lng=en&tlng=en
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author Victor Dayan
Diego Perez
Eloisa Silva
Gerardo Soca
Jorge Estigarribia
author_facet Victor Dayan
Diego Perez
Eloisa Silva
Gerardo Soca
Jorge Estigarribia
author_sort Victor Dayan
collection DOAJ
description Abstract Objective: In contrast to unstable angina, optimal therapy in patients with stable angina is debated. Our aim was to evaluate the outcomes of patients with stable angina scheduled for isolated coronary artery bypass grafts and the effect of preoperative use of beta-blockers. Overall and cardiovascular survivals were our primary outcome. Operative mortality and postoperative complications along with subgroup analysis of diabetic patients were our secondary outcomes. Methods: Retrospective evaluation of patients with stable angina scheduled for isolated coronary artery bypass grafts was included. Pre- and postoperative variables were extracted from the institution database. Survival was obtained from the National Registry. Results: We included 282 patients with stable angina, with a mean age of 65.6±9.5 years. 26.6% were female and 38.7% had diabetes. Three-vessel disease was present in 76.6% of patients. Previous beta-blocker treatment was evident in 69.9% of patients. 10-year overall survival in the whole population was 60.5% (95% confidence interval [CI]: 50.3-70.7%). Operative mortality during the study period was 3.5%. Patients with preoperative use of beta-blocker therapy had better overall survival (9.0 years, 95%CI: 8.6-9.5) than those without treatment (7.9 years, 95%CI: 7.1-8.8 years; P=0.048). Predictors for overall survival were: hypertension, diabetes, and age. Predictors for cardiovascular survival in diabetic patients were: beta-blocker use, gender, and age. Conclusion: Coronary artery bypass grafts surgery in patients with stable angina carries low operative mortality, postoperative complications, and excellent long-term cardiovascular survival. The preoperative use of beta-blockers in diabetic patients is associated with better cardiovascular survival after coronary artery bypass grafts.
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spelling doaj.art-1fa734cc397843fba14b94469f83c2f42022-12-22T00:26:34ZengSociedade Brasileira de Cirurgia CardiovascularBrazilian Journal of Cardiovascular Surgery1678-9741331475310.21470/1678-9741-2017-0138S0102-76382018000100047CABG and Preoperative use of Beta-Blockers in Patients with Stable Angina are Associated with Better Cardiovascular SurvivalVictor DayanDiego PerezEloisa SilvaGerardo SocaJorge EstigarribiaAbstract Objective: In contrast to unstable angina, optimal therapy in patients with stable angina is debated. Our aim was to evaluate the outcomes of patients with stable angina scheduled for isolated coronary artery bypass grafts and the effect of preoperative use of beta-blockers. Overall and cardiovascular survivals were our primary outcome. Operative mortality and postoperative complications along with subgroup analysis of diabetic patients were our secondary outcomes. Methods: Retrospective evaluation of patients with stable angina scheduled for isolated coronary artery bypass grafts was included. Pre- and postoperative variables were extracted from the institution database. Survival was obtained from the National Registry. Results: We included 282 patients with stable angina, with a mean age of 65.6±9.5 years. 26.6% were female and 38.7% had diabetes. Three-vessel disease was present in 76.6% of patients. Previous beta-blocker treatment was evident in 69.9% of patients. 10-year overall survival in the whole population was 60.5% (95% confidence interval [CI]: 50.3-70.7%). Operative mortality during the study period was 3.5%. Patients with preoperative use of beta-blocker therapy had better overall survival (9.0 years, 95%CI: 8.6-9.5) than those without treatment (7.9 years, 95%CI: 7.1-8.8 years; P=0.048). Predictors for overall survival were: hypertension, diabetes, and age. Predictors for cardiovascular survival in diabetic patients were: beta-blocker use, gender, and age. Conclusion: Coronary artery bypass grafts surgery in patients with stable angina carries low operative mortality, postoperative complications, and excellent long-term cardiovascular survival. The preoperative use of beta-blockers in diabetic patients is associated with better cardiovascular survival after coronary artery bypass grafts.http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0102-76382018000100047&lng=en&tlng=enCoronary artery bypassAdrenergic betaantagonists/therapeutic useAngina, stablePreoperative Care/methods
spellingShingle Victor Dayan
Diego Perez
Eloisa Silva
Gerardo Soca
Jorge Estigarribia
CABG and Preoperative use of Beta-Blockers in Patients with Stable Angina are Associated with Better Cardiovascular Survival
Brazilian Journal of Cardiovascular Surgery
Coronary artery bypass
Adrenergic betaantagonists/therapeutic use
Angina, stable
Preoperative Care/methods
title CABG and Preoperative use of Beta-Blockers in Patients with Stable Angina are Associated with Better Cardiovascular Survival
title_full CABG and Preoperative use of Beta-Blockers in Patients with Stable Angina are Associated with Better Cardiovascular Survival
title_fullStr CABG and Preoperative use of Beta-Blockers in Patients with Stable Angina are Associated with Better Cardiovascular Survival
title_full_unstemmed CABG and Preoperative use of Beta-Blockers in Patients with Stable Angina are Associated with Better Cardiovascular Survival
title_short CABG and Preoperative use of Beta-Blockers in Patients with Stable Angina are Associated with Better Cardiovascular Survival
title_sort cabg and preoperative use of beta blockers in patients with stable angina are associated with better cardiovascular survival
topic Coronary artery bypass
Adrenergic betaantagonists/therapeutic use
Angina, stable
Preoperative Care/methods
url http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0102-76382018000100047&lng=en&tlng=en
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AT eloisasilva cabgandpreoperativeuseofbetablockersinpatientswithstableanginaareassociatedwithbettercardiovascularsurvival
AT gerardosoca cabgandpreoperativeuseofbetablockersinpatientswithstableanginaareassociatedwithbettercardiovascularsurvival
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