The effect of race and chronic obstructive pulmonary disease on long-term survival after coronary artery bypass grafting

Abstract

Background: Chronic obstructive pulmonary disease (COPD) is a known predictor of decreased long-term survival after coronary artery bypass grafting (CABG). Differences in survival by race have not been examined. Methods: A retrospective cohort study was conducted of CABG patients between 2002 and 2011. Long-term survival was compared in patients with and without COPD and stratified by race. Hazard ratios (HR) and 95% confidence intervals (CI) were computed using a Cox regression model. Results: A total of 984 (20%) patients had COPD (black nD182; white nD802) at the time of CABG (N D4,801). The median follow-up for study participantswas 4.4 years. COPDwas observed to be a statistically significant predictor of decreased survival independent of race following CABG (no COPD: HRD1.0; white COPD: adjusted HRD1.9, 95% CID1.7-2.3; black COPD: adjusted HRD1.6, 95% CID1.1-2.2). Conclusion: Contrary to the expected increased risk of mortality among black COPD patients in the general population, a similar survival disadvantage was not observed in our CABG population.