Impact of Factor V Leiden on Outcomes Following Coronary Artery Bypass Grafting: A National Inpatient Sample Analysis

Alec Czaplicki^1*Ashley Rensted¹Shannon Blee¹Eli Blaney¹Saif Zurob¹Tauseef Abubakar²Ali Bin Abdul Jabbar²

• ¹Creighton University School of Medicine, Omaha, United States
• ²Department of Medicine, Creighton University School of Medicine, Omaha, United States

Background: Coronary artery bypass grafting (CABG) is commonly used for revascularization in patients with advanced coronary artery disease. Factor V Leiden (FVL) is a hereditary hypercoagulable state in which factor V is resistant to activation by activated protein C, causing activation of prothrombin and an increased propensity for thrombotic events. In this study, we aim to establish whether FVL increases in-hospital mortality following a CABG procedure. Methods: The National Inpatient Sample was used to extract data on patients who underwent a CABG procedure between 2017–2022. Patients were grouped based on a diagnosis of FVL (N=2,095) or not (N=1,142,735). Propensity scores were estimated using logistic regressions and stratified into six subclassifications, and generalized linear models were used to assess differences in in-hospital mortality, length of stay, and total cost. Results: A higher proportion of patients with FVL were female (p=0.006) and white (p<0.001). There was no significant difference in in-hospital mortality between those with and without FVL who underwent a CABG procedure (95% CI 0.52 to 1.78, p=0.89). Those with FVL had 7% longer hospital stays (95% CI: 1.01 to 1.13, p=0.025) but did not incur higher costs for their stay (95% CI: 0.92 to 1.08, p=0.97) compared to those without FVL. Conclusions: FVL is not associated with increased risk of in-hospital mortality following a CABG procedure. This finding can help guide providers considering CABG for revascularization in patients with FVL.