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**4** 

**Psychiatric Factors Which Impact Coronary** 

**Post-Coronary Artery Bypass Grafting Surgery** 

It has been reported that over 13 million individuals in the United States have been diagnosed with Coronary Artery Disease (Morrow & Gersh, 2008), and it is the leading cause of death in the United States with more than 650,000 deaths in 2005 (Centers for Disease Control and Prevention, 2009). One of the most effective and common methods of treating Coronary Artery Disease is Coronary Artery Bypass Grafting surgery (Niles et al., 2001). Typically, those patients with severe narrowing of the left main coronary artery and/or those with disease in at

There is also a high comorbidity between Peripheral Vascular Disease and Coronary Artery Disease (Brandt et al., 2004; Eagle et al., 1994; Hertzer et al., 1984). While several studies have reported short-term adverse outcomes in Coronary Artery Bypass Grafting patients that also have Peripheral Vascular Disease (Gersh et al., 1989; Grover et al., 1990; Higgins et al., 1992; Kunadian et al., 2007; Magovern et al., 1996; O'Connor et al., 1992; Rosenthal et al., 2003; Sutton-Tyrrell et al., 1998) the long-term outcomes have not been thoroughly investigated. To address this gap in the literature, Chu et al. (2008) conducted a study investigating the long-term impact of Coronary Artery Bypass Grafting surgery in patients who concurrently had Peripheral Vascular Disease. After comparing 370 Peripheral Vascular Disease and 794 non-Peripheral Vascular Disease patients, Chu and colleagues determined there were no significant group differences in 30 day mortality or major cardiac adverse events; however, patients with Peripheral Vascular Disease had a significantly worse 9 year survival rate (i.e., almost twice the risk of mortality) when compared to those without Peripheral Vascular Disease. While the short-term outcomes of this study are contradictory to previous studies, the long-term outcomes suggest that those with Peripheral Vascular Disease have poorer outcomes over time when compared

least 3 coronary arteries are candidates for Coronary Artery Bypass Grafting Surgery.

**1. Introduction** 

**1.1 Coronary Artery Bypass Grafting defined** 

**1.2 Comorbidity with Coronary Artery Disease** 

to those without Peripheral Vascular Disease.

**Heart Disease and Influence Outcomes** 

James J. Mahoney, III1,2,3, Emily A. Voelkel1, Jenny A. Bannister1,

*1University of Houston, Department of Educational Psychology,* 

Raja R. Gopaldas4 and Tam K. Dao1,2

*3Michael E. DeBakey Veteran Affairs Medical Center, 4University of Missouri – Columbia School of Medicine,* 

*2Baylor College of Medicine,* 

*United States* 

