Incidence and trends of heart failure admissions after coronary artery bypass grafting surgery

Eur J Heart Fail. 2013 Jan;15(1):46-53. doi: 10.1093/eurjhf/hfs154. Epub 2012 Oct 24.


Aims: Factors related to hospitalization for heart failure (HF) following coronary artery bypass grafting (CABG) surgery were studied.

Methods and results: Patients (n = 65 377) undergoing CABG surgery in New Jersey from 1998 to 2007 were identified from the state cardiac surgery database; subsequent hospitalizations for HF were assessed using the Myocardial Infarction Data Acquisition System database. Patients were classified based on pre-operative ejection fraction (EF). Multivariate models were used to identify factors related to HF admission and mortality. Post-CABG HF admission rates among patients with pre-operative EF <35% increased over the 10-year period (P = 0.02), but no significant trend was seen among patients with EF ≥35%. Independent factors associated with post-CABG HF admission within 2 years were: EF, age, female gender, Black race, smoking, diabetes, renal disease, hypertension, and cerebrovascular disease. Pre-operative use of beta-blockers increased over the years (P < 0.0001) and reduced the risk of admission for HF by 13%, with greater benefit in patients with lower EF. Mortality remained unchanged from 1998 to 2007, averaging 1.8% in-hospital and 5.1% and 7.2% at 1-year and 2-year follow-up, respectively.

Conclusions: Pre-operative EF is a strong predictor of HF admission within 2 years after CABG surgery. The use of beta-blockers decreased HF admission after CABG, especially in patients with EF <35%. Despite the more pronounced benefit and increasing use of beta-blockers in patients with a low EF, HF admission rates in this group of patients are rising. This suggests that more comprehensive management of factors associated with HF is necessary.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Coronary Artery Bypass / adverse effects*
  • Coronary Artery Disease / physiopathology
  • Coronary Artery Disease / surgery*
  • Disease Progression
  • Female
  • Follow-Up Studies
  • Heart Failure / epidemiology*
  • Heart Failure / etiology
  • Heart Failure / physiopathology
  • Humans
  • Incidence
  • Male
  • New Jersey / epidemiology
  • Patient Admission*
  • Prognosis
  • Retrospective Studies
  • Risk Factors
  • Stroke Volume*