LAUSR

BACKGROUND Updated knowledge about survival after coronary artery bypass graft (CABG) surgery is needed. We examined 20-year trends in 4-year survival after a first isolated CABG procedure, compared with that of the general population. METHODS We identified 94,328 patients surviving 30days after a first isolated CABG 1987-2006 from the Swedish Inpatient Register. RESULTS Crude annual mortality rates remained stable at approximately 1% in patients aged 18-54years and at approximately 2% in those aged ≥55years. After adjustment for comorbidities, 4-year survival in men aged 18-54 and ≥55years improved by 37% (HR: 0.63, 95% CI, 0.46-0.88) and 31% (HR: 0.69, 95% CI, 0.63-0.76), respectively, (1987-1991 vs. 2002-2006). The corresponding estimate for women aged ≥55years was 38% (HR: 0.62, 95% CI, 0.52-0.75), with no significant change in survival in women aged <55years (HR: 1.02, 95% CI, 0.52-2.03). Men and women aged <55years had higher mortality than the general population, with standardized mortality ratios (SMR) of 1.76 (95% CI, 1.35-2.22) in men and 4.49 (95% CI, 2.74-6.68) in women during the last period (2002-2006). In contrast, patients aged ≥55years had better survival with a SMR of 0.74 (95% CI, 0.70-0.78) in men and 0.82 (95% CI, 0.74-0.91) in women during 2002-2006. CONCLUSION During 1987-2006, there was a significant improvement in survival after CABG for all categories, except in women aged <55years. Men and women aged ≥55years who survived the first 30days after CABG had a lower mortality risk than the general population.