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Age alone should not be a deterrent for recommending coronary bypass surgery

Despite a slower rate of physical recovery from coronary artery bypass graft (CABG) surgery than elderly patients who are younger, those older than 75 years derive similar health benefits from the procedure, according to a study supported in part by the Agency for Healthcare Research and Quality (HS11282). This finding suggests that age alone should not deter physicians from recommending bypass surgery, according to researchers from Saint Luke's Hospital and the University of Missouri-Kansas City.

They administered the Seattle Angina Questionnaire (SAQ), which quantifies clinical dimensions of coronary artery disease, to 690 elderly patients undergoing CABG at a single center at the time of their procedure (baseline) and 1 year later. The patients were divided into two age groups: those 75 years of age and younger and those older than 75 years.

The first 224 patients enrolled in the study also were given monthly questionnaires for 6 months after CABG. The goal was to compare the health status changes of both age groups (relief of symptoms, improvement in physical functioning, and enhanced quality of life) after CABG. Although surgical mortality was similar for both the older (2.6 percent) and younger patients (2.2 percent), 1-year mortality was greater in older patients (11.5 percent vs. 5.4 percent).

Among survivors, similar health status benefits were observed 1 year after surgery. SAQ change scores 1 year after CABG for the older and younger groups, respectively, were 21.5 versus 19.7 for physical functioning, 30.1 versus 24.6 for angina frequency, and 37.7 vs. 33.6 for quality of life. In the 224 patients assessed monthly, the older group's physical function scores were significantly lower than the younger group until 1 year, confirming a slower recovery of physical function. However, recovery speed for angina relief and quality of life improvement did not differ by age.

More details are in "The elderly: Health status benefits and recovery of function one year after coronary artery bypass surgery," by Darcy Green Conaway, M.D., John House, M.D., Kathleen Bandt, and others, in the October 15, 2003, Journal of the American College of Cardiology 42(8), pp. 1421-1426.

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