ASSESSING PREOPERATIVE PREDICTORS AND EARLY IMPROVEMENT OF EJECTION FRACTION AFTER CORONARY ARTERY BYPASS GRAFTING SURGERY IN PATIENTS WITH IMPAIRED LEFT VENTRICULAR FUNCTION AT PESHAWAR INSTITUTE OF CARDIOLOGY

Abstract

Background: Ischemic heart disease is the leading cause of death in Pakistan, and its occurrence in our population is increasing each day. Worldwide, Coronary Artery Bypass Grafting is an established and time-tested surgical procedure for the treatment of patients with ischemic heart disease. Materials and Methods: This was a single Retrospective Cohort Study conducted at the Cardiac Surgery Department of Peshawar Institute of Cardiology (PIC). Patients underwent isolated coronary artery bypass grafting (CABG) from January 2023 to March 2024 with a preoperative ejection fraction ≤40%, confirmed by echocardiography. The sample size for this study was 114. Results: The patients' mean age was 61.3 years, and they were generally overweight, with a mean BMI of 28.7. Preoperative cardiac function was moderately reduced (ECHO 36.4%), improving to 40.2% postoperatively. Surgery involved an average bypass time of 87.3 minutes and a cross-clamp time of 61.1 minutes. Renal function, likely measured by serum creatinine (CRT), showed improvement from a pre-op mean of 2.40 to a post-op value of 0.97 mg/dL. Conclusion: In patients with impaired LV systolic function undergoing CABG, diabetes mellitus independently predicts early EF improvement, underscoring its dual role as both risk factor and marker of functional recovery potential. Keywords: Coronary Artery Disease, Coronary Artery Bypass grafting, Ejection Fraction, Echocardiography, Cardiac Magnetic Resonance.