Short- and long-term cause of death in patients undergoing isolated coronary artery bypass grafting: A nationwide cohort study

Jawad H Butt; Rikke Sørensen; Caroline Bäck; Peter Skov Olsen; Kristinn Thorsteinsson; Christian Torp-Pedersen; Gunnar H. Gislason; Lars Køber; Emil L Fosbøl

doi:10.1016/j.jtcvs.2018.01.106

Short- and long-term cause of death in patients undergoing isolated coronary artery bypass grafting: A nationwide cohort study

Jawad H Butt, Rikke Sørensen, Caroline Bäck, Peter Skov Olsen, Kristinn Thorsteinsson, Christian Torp-Pedersen, Gunnar H. Gislason, Lars Køber, Emil L Fosbøl

Department of Clinical Medicine

6 Citations (Scopus)

Abstract

Objectives: Knowledge of the association between time and causes of death after coronary artery bypass grafting is sparse. We examined short- and long-term mortality and cause of death in patients undergoing coronary artery bypass grafting. Methods: With the use of Danish nationwide registries, we identified all patients undergoing isolated coronary artery bypass grafting from 1998 to 2014. Cause of death was classified as cardiovascular or noncardiovascular according to death certificates. Landmark analyses of the cumulative incidences of cardiovascular and noncardiovascular mortality after 1, 3, and 5 years after coronary artery bypass grafting were performed. Multivariable cause-specific Cox regression models were used to evaluate changes over time in the risk of all-cause, cardiovascular, and noncardiovascular mortality after 1 and 7 years after coronary artery bypass grafting, respectively. Results: Among 37,495 included patients, 12,230 (32.6%) died during a median follow-up of 7.4 years. Causes of death were classified as cardiovascular in 6459 patients (52.8%) and noncardiovascular in 5771 patients (47.2%). Within the first year, the incidence of cardiovascular death was higher compared with noncardiovascular death (3.9% vs 1.1%, P <.001). The cumulative incidences of cardiovascular and noncardiovascular were deaths similar in the periods 1 to 3 years (2.3% vs 2.6%, P =.004), 3 to 5 years (3.1% vs 3.2%, P =.75), and 5 to 7 years postsurgery (3.7% vs 4.0%, P =.07). The crude rates and adjusted risks of short- and long-term all-cause and cardiovascular mortality decreased during the study period despite an increase in age and burden of comorbidities. Conclusions: In patients undergoing coronary artery bypass grafting, cardiovascular causes were responsible for the majority of deaths within the first year. Deaths due to noncardiovascular causes gained importance over time elapsed since coronary artery bypass grafting.

Original language	English
Journal	The Journal of Thoracic and Cardiovascular Surgery
Volume	156
Issue number	1
Pages (from-to)	54-60.e4
ISSN	0022-5223
DOIs	https://doi.org/10.1016/j.jtcvs.2018.01.106
Publication status	Published - Jul 2018

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10.1016/j.jtcvs.2018.01.106

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Butt, J. H., Sørensen, R., Bäck, C., Olsen, P. S., Thorsteinsson, K., Torp-Pedersen, C., Gislason, G. H., Køber, L., & Fosbøl, E. L. (2018). Short- and long-term cause of death in patients undergoing isolated coronary artery bypass grafting: A nationwide cohort study. The Journal of Thoracic and Cardiovascular Surgery, 156(1), 54-60.e4. https://doi.org/10.1016/j.jtcvs.2018.01.106

Short- and long-term cause of death in patients undergoing isolated coronary artery bypass grafting : A nationwide cohort study. / Butt, Jawad H; Sørensen, Rikke; Bäck, Caroline et al.

In: The Journal of Thoracic and Cardiovascular Surgery, Vol. 156, No. 1, 07.2018, p. 54-60.e4.

Research output: Contribution to journal › Journal article › Research › peer-review

Butt, JH, Sørensen, R, Bäck, C, Olsen, PS, Thorsteinsson, K, Torp-Pedersen, C, Gislason, GH , Køber, L & Fosbøl, EL 2018, 'Short- and long-term cause of death in patients undergoing isolated coronary artery bypass grafting: A nationwide cohort study', The Journal of Thoracic and Cardiovascular Surgery, vol. 156, no. 1, pp. 54-60.e4. https://doi.org/10.1016/j.jtcvs.2018.01.106

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title = "Short- and long-term cause of death in patients undergoing isolated coronary artery bypass grafting: A nationwide cohort study",

abstract = "Objectives: Knowledge of the association between time and causes of death after coronary artery bypass grafting is sparse. We examined short- and long-term mortality and cause of death in patients undergoing coronary artery bypass grafting. Methods: With the use of Danish nationwide registries, we identified all patients undergoing isolated coronary artery bypass grafting from 1998 to 2014. Cause of death was classified as cardiovascular or noncardiovascular according to death certificates. Landmark analyses of the cumulative incidences of cardiovascular and noncardiovascular mortality after 1, 3, and 5 years after coronary artery bypass grafting were performed. Multivariable cause-specific Cox regression models were used to evaluate changes over time in the risk of all-cause, cardiovascular, and noncardiovascular mortality after 1 and 7 years after coronary artery bypass grafting, respectively. Results: Among 37,495 included patients, 12,230 (32.6%) died during a median follow-up of 7.4 years. Causes of death were classified as cardiovascular in 6459 patients (52.8%) and noncardiovascular in 5771 patients (47.2%). Within the first year, the incidence of cardiovascular death was higher compared with noncardiovascular death (3.9% vs 1.1%, P <.001). The cumulative incidences of cardiovascular and noncardiovascular were deaths similar in the periods 1 to 3 years (2.3% vs 2.6%, P =.004), 3 to 5 years (3.1% vs 3.2%, P =.75), and 5 to 7 years postsurgery (3.7% vs 4.0%, P =.07). The crude rates and adjusted risks of short- and long-term all-cause and cardiovascular mortality decreased during the study period despite an increase in age and burden of comorbidities. Conclusions: In patients undergoing coronary artery bypass grafting, cardiovascular causes were responsible for the majority of deaths within the first year. Deaths due to noncardiovascular causes gained importance over time elapsed since coronary artery bypass grafting.",

author = "Butt, {Jawad H} and Rikke S{\o}rensen and Caroline B{\"a}ck and Olsen, {Peter Skov} and Kristinn Thorsteinsson and Christian Torp-Pedersen and Gislason, {Gunnar H.} and Lars K{\o}ber and Fosb{\o}l, {Emil L}",

year = "2018",

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doi = "10.1016/j.jtcvs.2018.01.106",

language = "English",

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TY - JOUR

T1 - Short- and long-term cause of death in patients undergoing isolated coronary artery bypass grafting

T2 - A nationwide cohort study

AU - Butt, Jawad H

AU - Sørensen, Rikke

AU - Bäck, Caroline

AU - Olsen, Peter Skov

AU - Thorsteinsson, Kristinn

AU - Torp-Pedersen, Christian

AU - Gislason, Gunnar H.

AU - Køber, Lars

AU - Fosbøl, Emil L

PY - 2018/7

Y1 - 2018/7

N2 - Objectives: Knowledge of the association between time and causes of death after coronary artery bypass grafting is sparse. We examined short- and long-term mortality and cause of death in patients undergoing coronary artery bypass grafting. Methods: With the use of Danish nationwide registries, we identified all patients undergoing isolated coronary artery bypass grafting from 1998 to 2014. Cause of death was classified as cardiovascular or noncardiovascular according to death certificates. Landmark analyses of the cumulative incidences of cardiovascular and noncardiovascular mortality after 1, 3, and 5 years after coronary artery bypass grafting were performed. Multivariable cause-specific Cox regression models were used to evaluate changes over time in the risk of all-cause, cardiovascular, and noncardiovascular mortality after 1 and 7 years after coronary artery bypass grafting, respectively. Results: Among 37,495 included patients, 12,230 (32.6%) died during a median follow-up of 7.4 years. Causes of death were classified as cardiovascular in 6459 patients (52.8%) and noncardiovascular in 5771 patients (47.2%). Within the first year, the incidence of cardiovascular death was higher compared with noncardiovascular death (3.9% vs 1.1%, P <.001). The cumulative incidences of cardiovascular and noncardiovascular were deaths similar in the periods 1 to 3 years (2.3% vs 2.6%, P =.004), 3 to 5 years (3.1% vs 3.2%, P =.75), and 5 to 7 years postsurgery (3.7% vs 4.0%, P =.07). The crude rates and adjusted risks of short- and long-term all-cause and cardiovascular mortality decreased during the study period despite an increase in age and burden of comorbidities. Conclusions: In patients undergoing coronary artery bypass grafting, cardiovascular causes were responsible for the majority of deaths within the first year. Deaths due to noncardiovascular causes gained importance over time elapsed since coronary artery bypass grafting.

AB - Objectives: Knowledge of the association between time and causes of death after coronary artery bypass grafting is sparse. We examined short- and long-term mortality and cause of death in patients undergoing coronary artery bypass grafting. Methods: With the use of Danish nationwide registries, we identified all patients undergoing isolated coronary artery bypass grafting from 1998 to 2014. Cause of death was classified as cardiovascular or noncardiovascular according to death certificates. Landmark analyses of the cumulative incidences of cardiovascular and noncardiovascular mortality after 1, 3, and 5 years after coronary artery bypass grafting were performed. Multivariable cause-specific Cox regression models were used to evaluate changes over time in the risk of all-cause, cardiovascular, and noncardiovascular mortality after 1 and 7 years after coronary artery bypass grafting, respectively. Results: Among 37,495 included patients, 12,230 (32.6%) died during a median follow-up of 7.4 years. Causes of death were classified as cardiovascular in 6459 patients (52.8%) and noncardiovascular in 5771 patients (47.2%). Within the first year, the incidence of cardiovascular death was higher compared with noncardiovascular death (3.9% vs 1.1%, P <.001). The cumulative incidences of cardiovascular and noncardiovascular were deaths similar in the periods 1 to 3 years (2.3% vs 2.6%, P =.004), 3 to 5 years (3.1% vs 3.2%, P =.75), and 5 to 7 years postsurgery (3.7% vs 4.0%, P =.07). The crude rates and adjusted risks of short- and long-term all-cause and cardiovascular mortality decreased during the study period despite an increase in age and burden of comorbidities. Conclusions: In patients undergoing coronary artery bypass grafting, cardiovascular causes were responsible for the majority of deaths within the first year. Deaths due to noncardiovascular causes gained importance over time elapsed since coronary artery bypass grafting.

U2 - 10.1016/j.jtcvs.2018.01.106

DO - 10.1016/j.jtcvs.2018.01.106

M3 - Journal article

C2 - 29627184

SN - 0022-5223

VL - 156

SP - 54-60.e4

JO - Journal of Thoracic and Cardiovascular Surgery

JF - Journal of Thoracic and Cardiovascular Surgery

IS - 1

ER -

Short- and long-term cause of death in patients undergoing isolated coronary artery bypass grafting: A nationwide cohort study

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