Outcomes and long-term survival of coronary artery surgery: The controversial role of opium as risk marker

Table 1 Basic demographic and clinical characteristics of patients, univariate analysis for overall survival using Cox regression

	Alive (n = 513)	Dead (n = 53)	Hazard ratio (95%CI)	P value
Age (yr)	58.5 ± 8.81	64.6 ± 8.27	1.08 (1.044-1.117)	< 0.001
Gender (male)	382 (74.5)	43 (81.1)	1.425 (0.716-2.837)	0.313
BMI (kg/m2)	27.4 ± 4.04	26.5 ± 4.39	0.947 (0.881-1.019)	0.146
Waist circumference (cm)	101.3 ± 1.46	100.2 ± 2.95	0.962 (0.85-1.09)	0.543
FC				0.141
I	177 (34.6)	21 (39.6)
II	263 (51.5)	20 (37.7)	0.701 (0.379-1.295)	0.256
III	71 (13.9)	12 (22.6)	1.433 (0.702-2.924)	0.323
EF (%)	49.1 ± 10.07	42.2 ± 11.07	0.94 (0.915-0.965)	< 0.001
FH	251 (49.1)	18 (34)	0.5 (0.282-0.887)	0.018
Smoking	183 (35.8)	20 (37.7)	0.954 (0.542-1.678)	0.870
Alcohol	66 (13.7)	5 (9.8)	0.523 (0.201-1.363)	0.185
Opium	69 (13.5)	13 (24.5)	1.939 (1.032-3.644)	0.040
DM	204 (39.9)	28 (52.8)	1.789 (1.033-3.097)	0.038
HLP	366 (71.6)	32 (60.4)	0.58 (0.334-1.008)	0.053
HTN	253 (49.5)	26 (49.1)	1.033 (0.602-1.774)	0.906
CVA	16 (3.1)	6 (11.3)	4.146 (1.761-9.76)	0.001
PVD	136 (26.6)	22 (41.5)	2.166 (1.246-3.766)	0.006
MI	254 (49.9)	32 (61.5)	1.61 (0.92-2.816)	0.095
Alb (g/dL)	4.6 ± 0.32	4.5 ± 0.39	0.351 (0.16-0.77)	0.009
FBS	96 (87-117)	98 (84-124)	1.004 (0.997-1.011)	0.266
BUN	38 (31-46)	40 (33-52)	1.035 (1.016-1.054)	< 0.001
Cr	1.2 ± 0.27	1.3 ± 0.26	2.009 (0.832-4.856)	0.121
Mg	1.9 ± 0.34	1.9 ± 0.39	1.15 (0.421-3.143)	0.785
HCT	42.3 ± 5.92	42.8 ± 3.82	1.013 (0.979-1.047)	0.462
TG	165 (115-210)	126 (97-173)	0.994 (0.990-0.999)	0.010
Chol	160 ± 44.86	166.3 ± 48.06	1.003 (0.997-1.008)	0.347
LP	23 (12-45)	28 (15-54)	1.006 (0.997-1.016)	0.191
CRP	5.75 (4.9-7)	6.35 (4.82-8.57)	1.001 (0.99-1.013)	0.814
LDL	82 (59-105)	86 (68-114)	1.003 (0.997-1.009)	0.280
HDL	40.3 ± 8.5	42.8 ± 9.37	1.031 (1-1.062)	0.049
No. of diseased vessel				0.473
1	19 (3.7)	2 (3.8)
2	99 (19.4)	7 (13.2)	0.616 (0.127-2.976)	0.547
3	393 (76.9)	44 (83)	1.013 (0.245-4.191)	0.985
No. of grafts	3.7 ± 0.94	3.9 ± 1.02	1.234 (0.922-1.650)	0.158
Euro score				0.017
Low (0-2)	301 (58.9)	20 (37.7)
Moderate (3-5)	171 (33.5)	25 (47.2)	2.089 (1.160-3.762)	0.014
High (6-8)	32 (6.3)	6 (11.3)	2.851 (1.143-7.110)	0.025
Very high (≥ 9)	7 (1.4)	2 (3.8)	4.479 (1.044-19.220)	0.044

Data are shown as mean ± SD, median (25^th-75^th percentiles) or number (%). BMI: Body mass index; FC: Functional class; EF: Ejection fraction; FH: Family history; DM: Diabetes mellitus; HLP: Hyperlipidemia; HTN: Hypertension; CVA: Cerebrovascular accident; PVD: Peripheral vascular disease; MI: Myocardial infarction; Alb: Albumin; FBS: Fasting blood sugar; BUN: Blood urea nitrogen; Cr: Creatinine; Mg: Magnesium; HCT: Hematocrit; TG: Triglyceride; Chol: Cholestrol; LP: Lipoprotein; CRP: C-reactive protein; LDL: Low density lipoprotein; HDL: High density lipoprotein.

Table 2 Baseline characteristics of patients base on opium consumption

	All patients (n = 566)	Opium + (n = 82)	Opium - (n = 484)	P value
Age (yr)	59.08 ± 8.9	55.9 ± 8.3	59.6 ± 8.9	< 0.001
Gender (male)	425 (75.1)	80 (97.6)	345 (71.3)	< 0.001
BMI (kg/m2)	27.3 ± 4.08	25.7 ± 3.6	27.6 ± 4.08	< 0.001
Waist circumference (cm)	101.3 ± 11.3	100.3 ± 9.3	101.5 ± 11.6	0.514
FC				0.531
I	198 (35)	33 (40.2)	165 (34.2)
II	283 (50)	39 (47.6)	244 (50.6)
III	83 (14.7)	10 (12.2)	73 (15.1)
EF (%)	48.5 ± 10.3	44.9 ± 9.4	49.1 ± 10.3	0.001
FH	269 (47.5)	44 (53.7)	225 (46.7)	0.242
Smoking	203 (35.9)	67 (81.7)	136 (28.2)	< 0.001
Alcohol	71 (12.5)	29 (37.7)	42 (9.2)	< 0.001
DM	232 (41)	26 (31.7)	206 (42.7)	0.061
HLP	398 (70.3)	48 (58.5)	350 (72.6)	0.010
HTN	279 (49.3)	30 (36.6)	249 (51.7)	0.012
CVA	22 (3.9)	4 (4.9)	18 (3.7)	0.545
PVD	158 (27.9)	21 (25.6)	137 (28.4)	0.600
MI	286 (50.5)	58 (71.6)	228 (47.5)	< 0.001
Alb (g/dL)	4.6 ± 0.3	4.5 ± 0.3	4.6 ± 0.3	0.200
FBS	96 (87-118)	92 (81-106)	97 (88-119)	0.011
BUN	38 (31-46)	35 (27-42)	39 (32-47)	0.004
Cr	1.2 ± 0.2	1.3 ± 0.3	1.2 ± 0.2	0.024
Mg	1.9 ± 0.3	1.8 ± 0.3	1.9 ± 0.3	0.314
HCT	42.3 ± 5.7	42.2 ± 3.6	42.4 ± 6.04	0.848
TG	159 (113-205)	150 (107-194)	162 (113-208)	0.353
Chol	157 (129-186)	156 (124-177)	157 (129-188)	0.167
LP	23 (12-46)	24 (9-44)	23 (13-47)	0.432
CRP	5.8 (4.9-7.2)	5.8 (4.8-7.1)	5.8 (4.9-7.2)	0.617
LDL	83 (60-106)	85 (60.7-100.5)	82.5 (60-110)	0.517
HDL	40.5 ± 8.6	39.4 ± 8.5	40.7 ± 8.6	0.205
No. of diseased vessel				0.733
1	21 (307)	2 (2.4)	19 (3.9)
2	106 (18.7)	17 (20.7)	89 (18.5)
3	437 (77.2)	63 (76.8)	374 (77.6)
No. of grafts	4 (3-4)	4 (3-5)	4 (3-4)	0.400
Euro score				0.199
Low (0-2)	321 (56.7)	45 (54.9)	276 (57.3)
Moderate (3-5)	196 (34.6)	26 (31.7)	170 (35.5)
High (6-8)	38 (6.7)	10 (12.2)	28 (5.8)
Very high (≥ 9)	9 (1.6)	1 (1.2)	8 (1.7)

Data are shown as mean ± SD, median (25^th-75^th percentiles) or number (%). BMI: Body mass index; FC: Functional class; EF: Ejection fraction; FH: Family history; DM: Diabetes mellitus; HLP: Hyperlipidemia; HTN: Hypertension; CVA: Cerebrovascular accident; PVD: Peripheral vascular disease; MI: Myocardial infarction; Alb: Albumin; FBS: Fasting blood sugar; BUN: Blood urea nitrogen; Cr: Creatinine; Mg: Magnesium; HCT: Hematocrit; TG: Triglyceride; Chol: Cholesterol; LP: Lipoprotein; CRP: C-reactive protein; LDL: Low density lipoprotein; HDL: High density lipoprotein.

Table 3 Multivariable model for all-cause mortality using Cox regression

	Hazard ratio (95%CI)	P value
Age (per 10 yr increase)	2.46 (1.64-3.70)	< 0.001
Opium	2.09 (0.99-4.39)	0.052
BMI	0.89 (0.82-0.96)	0.004
FC		0.653
II vs I	0.86 (0.44-1.66)	0.653
III vs II	2.18 (0.97-4.88)	0.057
EF (per 5% increase)	0.71 (0.62-0.81)	< 0.001
DM	2.97 (1.59-5.54)	0.001
CVA	3.45 (1.30-9.16)	0.013

BMI: Body mass index; FC: Functional class; EF: Ejection fraction; DM: Diabetes mellitus; CVA: Cerebrovascular accident.