Survival, clinical status and quality of life five years after coronary surgery. The ARCA study.

INTRODUCTION AND OBJECTIVES: Little is known about the long-term outcomes of coronary surgery and their determinants in Spain. The objectives of this study were to evaluate clinical outcomes, quality of life and survival in a cohort of patients 5 years after undergoing a first aortocoronary bypass operation without any other associated procedure. METHODS: Patients who survived the operation and whose pre- and postoperative data had been collected prospectively were followed up by telephone interview after 5 years. RESULTS: Information was available after 5 years on 1,300 (85.2%) of the 1,525 patients who survived until hospital discharge. Of these, 13.6% had died, while 24% had either died, undergone revascularization or were readmitted because of a cardiac complaint. The cumulative survival rate (excluding the period of hospitalization) was 0.87 (95% confidence interval, 0.85-0.89). Mortality varied significantly with the level of preoperative risk (i.e. the EuroSCORE), to the extent that mortality in the low-risk group was equivalent to that in the general reference population. CONCLUSIONS: Three-quarters of patients who survived until hospital discharge after coronary surgery did not experience a major cardiac event within 5 years and their level of functioning and quality of life were good. The survival rate after the immediate postoperative period varied according to the patient's preoperative risk profile and, in low-risk patients, was equivalent to that in the general reference population.

Supervivencia, estado clínico y calidad de vida a los cinco años de la cirugía coronaria. Estudio ARCA / Survival, clinical status and quality of life five years after coronary surgery. The arca study

Introducción y objetivos. El resultado tardío de la cirugía coronaria y sus determinantes son poco conocidos en España. Este estudio evalúa la evolución clínica, la calidad de vida y la supervivencia de una cohorte de pacientes, transcurridos 5 años de un primer injerto aortocoronario sin otros procedimientos asociados. Métodos. Seguimiento telefónico a los 5 años a los supervivientes de la operación, de los que se había recogido prospectivamente los datos preoperatorios y postoperatorios. Resultados. De los 1.525 pacientes dados de alta vivos, a los 5 años se obtuvo información de 1.300 (85,2%), de los que el 13,6% había fallecido y el 24% había fallecido o había sido revascularizado o ingresado por causa cardiaca. La supervivencia acumulada (excluyendo la fase hospitalaria) fue de 0,87 (intervalo de confianza [IC] del 95%, 0,85-0,89). La tasa de mortalidad fue distinta según el riesgo preoperatorio (EuroSCORE); la del grupo con bajo riesgo fue equivalente a la de la población general de referencia. Conclusiones. De cada 4 supervivientes al alta 3 están libres de eventos mayores a los 5 años, con buenas capacidad funcional y calidad de vida. La supervivencia después del postoperatorio inmediato varía en función de las características prequirúrgicas de riesgo y en el grupo con bajo riesgo es equivalente a la de la población general de referencia (AU)

Introduction and objectives. Little is known about the long-term outcomes of coronary surgery and their determinants in Spain. The objectives of this study were to evaluate clinical outcomes, quality of life and survival in a cohort of patients 5 years after undergoing a first aortocoronary bypass operation without any other associated procedure.Methods. Patients who survived the operation and whose pre- and postoperative data had been collected prospectively were followed up by telephone interview after 5 years.Results. Information was available after 5 years on 1,300 (85.2%) of the 1,525 patients who survived until hospital discharge. Of these, 13.6% had died, while 24% had either died, undergone revascularization or were readmitted because of a cardiac complaint. The cumulative survival rate (excluding the period of hospitalization) was 0.87 (95% confidence interval, 0.85-0.89). Mortality varied significantly with the level of preoperative risk (i.e. the EuroSCORE), to the extent that mortality in the low-risk group was equivalent to that in the general reference population.Conclusions. Three-quarters of patients who survived until hospital discharge after coronary surgery did not experience a major cardiac event within 5 years and their level of functioning and quality of life were good. The survival rate after the immediate postoperative period varied according to the patient’s preoperative risk profile and, in low-risk patients, was equivalent to that in the general reference population (AU)