Abstract
<title>Abstract</title> <p>Background Ischemic heart disease complicated by a reduced ejection fraction drastically increases morbidity and mortality following coronary artery bypass grafting (CABG). This study aims to evaluate the short-term and long-term clinical outcomes—specifically survival rates, readmissions, and stroke incidence—in this high-risk patient population. Methods This cross-sectional study analyzed 229 patients with heart failure (ejection fraction < 40%) who underwent CABG at Ayatollah Rouhani Hospital in Babol, Iran, between 2011 and 2019. Demographic information, medical history, and clinical outcomes were extracted from hospital records and follow-up interviews. Data were analyzed using SPSS software via descriptive statistics, Chi-square tests, ANOVA, and Kaplan-Meier survival analyses. Results The cohort consisted of 153 men (66.8%) and 76 women (33.2%) with a mean age of 64.48 ± 10.92 years. Baseline comorbidities included hypertension (57.6%), hyperlipidemia (49.8%), and diabetes (46.7%). Over the follow-up period, 45 patients (19.7%) died. The mean survival time was 58.36 months (95% CI: 55.78–60.95). Older age (> 65 years) was significantly associated with decreased survival (p < 0.001) and higher readmission rates (p < 0.001). Moderate-to-severe mitral regurgitation also significantly reduced survival (p = 0.027). Post-operative stroke occurred in 5.2% of patients. Higher educational levels correlated with lower readmission probabilities (p = 0.004). Conclusions CABG remains a critical intervention for heart failure patients with reduced ejection fraction, yielding a mean survival of over 58 months. However, advanced age and significant mitral regurgitation are profound predictors of mortality and readmission. Identifying these clinical factors can guide targeted postoperative monitoring and improve long-term survival in vulnerable cohorts.</p>