Adult: CoronaryHistory of cancer and survival after coronary artery bypass grafting: Experiences from the SWEDEHEART registry
Graphical abstract
Section snippets
Study Population
All patients older than 18 years of age undergoing isolated first-time CABG in Sweden from January 1, 1997, to December 31, 2015, were included. The study population was identified in the Swedish Cardiac Surgery Registry,5 which is part of the SWEDEHEART registry.6 The patients were followed until December 31, 2015, or to death or emigration.
A total of 194 clinical variables were collected for each patient, including demographic data, medical history, preoperative medications, clinical symptoms
Patient Characteristics
Patient demographics are shown in Table 1. There was no missing data regarding comorbidity. Altogether, 82,137 patients underwent isolated first-time CABG surgery in Sweden from 1997 to 2015. Median follow-up time was 9.0 years (interquartile range, 4.8-13.1) in the total group, 5.9 years (interquartile range, 2.7-9.6) in the history of cancer group, and 9.3 years (interquartile range, 5.1-13.3) in the no history of cancer group. The total follow-up time was 738,436 years. During follow-up, 328
Discussion
There are 2 main findings in this large population-based study. First, the proportion of CABG patients with a history of cancer has markedly increased over time. Second, history of cancer at the time of surgery is associated with an increased long-term risk for all-cause and cancer death but not cardiovascular death. Hence, the same cardiovascular prognosis after CABG may be expected in patients with and without a history of cancer.
These results clearly demonstrate an increasing prevalence of
Conclusions
The proportion of patients undergoing CABG with a history of cancer is increasing significantly. History of cancer at the time of surgery increases the risk for all-cause and cancer mortality but not cardiovascular death (Figure 3). The results suggest that the same cardiovascular prognosis after CABG can be achieved in patients with and without a history of cancer.
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Funding: The Competitive State Research Financing of the Expert Responsibility area of Tampere University Hospital (A.M.); The Swedish Heart-Lung Foundation (20150587, 20180560 to A.J.); the Swedish state under the agreement between the Swedish government and the county councils concerning economic support of research and education of doctors (ALF agreement) (ALFGBG-725131 to A.J.); and Västra Götaland Region (VGFOUREG-847811 to A.J.). The supporting bodies had no influence on the analysis and interpretation of data, on the writing of the report, or on the decision to submit the paper for publication.
Accepted for the 100th Annual Meeting of The American Association for Thoracic Surgery.