Background: Coronary artery disease (CAD) as defined by Kirklin2 is significant narrowing of the coronary arteries secondary to arteriosclerosis, which initially is limited to decreased coronary reserve but if severe enough would eventually lead to reduced blood flow to the affected artery and vessel occlusion. Indications for intervention would
depend on the patient's clinical presentation, severity of the disease, and status of ventricular function.3 This study aims to present the clinical outcome of patients with CAD and severe preoperative LV dysfunction after undergoing CABG in our institution. It is also intended to serve as a potential model for further improving patient management, which will allow reliable conclusions on the effects of LV dysfunction consequently reducing long-term disease risks.
Method: Patients aged 19-70 years old with severe LV dysfunction from 2010-2014 who underwent CABG were studied. Severe LV dysfunction was defined as having an EF of <35% based from the STICH Trial.7 Preoperative, operative and postoperative factors affecting outcome were analyzed.
Results: A total of fifty patients with impaired left ventricular function (EF< 35) underwent CABG with a male preponderance of 88%. The mean ejection fraction was 28.1 + 5.3%. In-hospital mortality was 6%(3/49). Diabetes mellitus, with an Odds ratio and p-value of 2.5 and 0.003 respectively, was identified as the most significant factor
associated with morbidity/mortality.
Conclusion: Diabetes Mellitus was the significant factor associated with MACE in patients with severe LV dysfunction undergoing CABG, which contributes to overall morbidity/mortality.