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Very Long Term Survival After CABG
27 Year Survival After CABG
Older adults with stable CAD who underwent bypass surgery had better long-term survival rates than those who underwent PCI. While there were no survival differences between the two groups after one year, after four years the CABG group had a 21% lower mortality rate.
I have reviewed the issue of long term survival extensively with other studies that include the SYNTAX trial. However, none have adressed survival beyond 5 years.
With an annual mortality rate (if not treated) for patients with stable coronary artery disease of about 2% and 10-20%/year in the patient population operated by me, 25+ year survivals must be remarkable.
This is what I learned this past week:
A secretary from one of the State's cardiology offices called and asked about one of my patients. To my delight I learned this regarded a patient operated in 1988. When asked she said he was doing fine, but had just called to make a routine office appointment.
I called back later for more details, but couldn't remember the name. However, since I have maintained my patients data till 2001 when I retired, I looked up that year, and mentioned some of the names on my list; of the first ten, five were active patients in their practice!
The following image shows my patient's long-term survival up to 200 months after their surgery (data collected from 1983-2001, 93% of female and 86% of male patients alive 16 years later after their bypass surgery):
Long Term Survival:
Patient Characteristics show these patients were high risk and had a very low morbidity/mortality:
Although this is incidental information, I now know that at least five patients are alive 27 years after their bypass surgery. A comparison with available literature shows that most investigations limit their reviews to less then 10 years after an intervention such as a stent or bypass surgery. Of significance, there are very few survival studies out there!
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