Impact of smoking status on early and late outcomes after isolated coronary artery bypass graft surgery.

Background: There are limited data on the impact of smoking status on outcomes after isolated coronary artery bypass graft (CABG) surgery. Methods: Data obtained prospectively between June 2001 and December 2009 by the Australian and New Zealand Society of Cardiac and Thoracic Surgeons Cardiac Surgery Database Program were ret-rospectively analyzed. Demographic and operative data were compared between patients who were non-smokers, previous smokers, and current smokers. The independent impact of smoking status on 14 short-term complications and long-term mortality was determined using binary logistic and Cox regression, respectively Results: Isolated CABG surgery was performed in 21 534 patients; smoking status was recorded in 21 486 (99.8%). Of these, 7023 (32.6%) had no previous smoking history, 11 183 (59.1%) were previous smok-ers, and 3290 (15.2%) were current smokers. The 30-day mortality rate was 1.8% in non-smokers, 1.5% in previous smokers, and 1.5% in current smokers (p = NS). The incidence of peri-operative compli-cations was generally similar in the three groups, but current smokers were at an increased risk of pneumonia (p< 0.001), and multisystem failure (p = 0.003). The mean follow-up period for this study was 37 months (range, 0-106 months). After adjusting for differences in patient variables, the inci-dence of late mortality was higher in previous smokers [hazard ratio (HR), 1.73; 95% confidence interval (CI), 1.47-2.05; p<0.001] or current smokers (HR, 1.41; 95% CI, 1.26-1.59; p<0.001) compared to non-smokers. Conclusion: Smoking status is not associated with early mortality after isolated CABG. It is, however, associated with an increased risk of pulmonary complications and reduced long-term survival. [ABSTRACT FROM AUTHOR]