The following is the summary of “Outcomes of Coronary Artery Bypass Grafting in Patients With Previous Mediastinal Radiation” published in the January 2023 issue of Cardiovascular Disease by Elzanaty, et al.

Those with coronary artery disease due to radiation therapy have been reported to have poorer outcomes with percutaneous revascularization. Internal mammary artery graft disease is predicted to increase in patients who have been exposed to radiation in the past. There is a paucity of research on the long-term effects of coronary artery bypass grafting (CABG) in patients exposed to radiation. Hospitalizations with CABG and a prior history of mediastinal radiation were retrieved from the National Readmission Database for 2016–2019. 

Hospital mortality, all-cause unplanned readmission rates within 90 days, and acute coronary syndrome readmission rates were examined about a patient’s history of mediastinal radiation using complex sampling multivariable logistic and linear regression models. The total number of hospitalizations considered in this study was 533,702 (2,070 in the irradiation history group and 531,632 in the control group). Traditional risk factors for coronary artery disease were lower in patients with a history of radiation therapy, although valvular disease was higher in this population. 

While the in-hospital mortality rate and the probability of readmission within 90 days were similar for patients with a history of irradiation, the cost of hospitalization was greater (β coefficient: $2,764; P=0.005). They were more likely to be readmitted within 90 days with acute coronary syndrome (adjusted odds ratio 1.67, P=0.02). In conclusion, prior mediastinal irradiation does not increase the risk of short-term mortality or readmission following coronary artery bypass grafting (CABG). However, it may be linked to higher rates of readmission for patients with acute coronary syndrome.

Source: sciencedirect.com/science/article/abs/pii/S0002914922011122