Mortality Difference Between the Sexes After Cabg Surgery (original) (raw)
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Circulation, 1993
BackgroundA prospective study of patients undergoing coronary artery bypass graft surgery (CABG) was conducted to examine differences in hospital mortality by sex. Outcome data on 3055 CABG patients undergoing operation between 1987 and 1989 were examined for differences in patient, disease, and treatment factors. Methods and ResultsOdds ratios (OR), risk differences, and 95% confidence intervals (CI95%) were calculated. Mortality rates for women (7.1%) and men (3.3%) differed, the OR (women versus men) being 2.23 (CI9%, 1.58 to 3.15). Women were older, more often diabetic, and had more urgent or emergent surgery; adjustment yielded an OR (women versus men) of 1.75 (CI95%, 1.17 to 2.63). Body surface area BSA) was associated with risk of death in both sexes (P=.007) and positively associated with coronary artery luminal diameters. After adjustment for BSA, sex was no longer significantly associated with mortality (OR [women versus men] of 1.18; CI95%, 0.72 to 1.95). Internal mammary...
Gender differences in outcomes following isolated coronary artery bypass grafting: long-term results
Journal of Cardiothoracic Surgery, 2016
Background: The main purpose of this study was to evaluate the impact of gender on outcomes after isolated coronary artery bypass grafting, in terms of 5-year rates of overall death, cardiac-related death, myocardial infarction, re-hospitalization, repeat percutaneous or surgical revascularization, stroke, new pacemaker implantation, postoperative renal failure, heart failure and need for long-term care. Methods: Two propensity-score matched cohorts, each of 1331 patients, undergoing isolated surgical coronary revascularization at the regional public and private centers of Emilia-Romagna region (Italy) from January 1st 2003 to December 31th 2013, were used to compare long-term outcomes of male (5976 patients) versus female gender (1332 patients). Results: In the matched cohort, males received significantly more bypass grafts (3.0 ± 1.0 vs 2.8 ± 1.0, p = 0.001). Left internal mammary artery use and total arterial revascularization were similarly performed in both matched subgroups. Both groups reported similar cumulative rate of all-cause, cardiac-related mortality and stroke at five years. Females experienced significantly higher rate of myocardial infarction, and not significantly higher occurrence of heart failure, and need for long-term care. Males experienced significantly higher rate of cumulative re-hospitalization and higher need for pacemaker implantation. Female gender was not an independent predictor of death at long-term follow-up. Conclusions: Women are more likely to be readmitted with myocardial infarction and congestive heart failure after CABG but experience survival similar to that observed in men. Female gender was not an independent risk factor for mortality. Prevention of new occurrence of postoperative myocardial infarction and enhancement of complete coronary revascularization should be future endpoints.
Indian Journal of Thoracic and Cardiovascular Surgery, 2001
Background. This study was aimed to determine influence of gender on result of coronary artery bypass grafting. It is a retrospective analysis. Methods. Ninety six patients, 48 men and 48 women of similar body surface area operated between 1991 to 1997 were compared. Associated comorbid conditions were identical in both the groups, except that none of the women smoked. Results. One patient (2.08%) died in each group. (p=NS). Although left anterior descending artery was smaller in diameter in women as compared to men, it did not express higher operative risk in women. No statistically significant difference was observed in perioperative and post operative morbidity including hospital stay. Conclusion. This study does not support the view that women carry higher surgical risk in comparison to men of similar body surface area.
Journal of the American College of Cardiology, 2007
This study sought to evaluate gender differences and trends in 30-day mortality after coronary artery bypass surgery (CABG). Background Evidence for gender differences in short-term mortality after CABG is conflicting. Many studies were from single centers, included highly selected populations, or had limited clinical information for adequate covariate adjustment. We undertook a population-based analysis using detailed clinical data on all adults undergoing CABG in the province of British Columbia, Canada. Methods The study population comprised all residents 20 years and older who underwent isolated CABG between 1991 and 2004. Multiple logistic regression was used to examine the association between gender and 30-day mortality; time trend analysis was conducted by Mantel-Haenszel chi-square test. Results The study cohort comprised 20,229 men and 4,983 women. Women were older and had more comorbid conditions than men, but had better ejection fractions and less extensive coronary disease. Thirty-day mortality decreased significantly in men (2.4% to 1.9%) and women (5.6% to 1.9%) over the 14-year study period. Overall, 30-day mortality was significantly higher in women (3.6% vs. 2.0%, p Ͻ 0.001), and adjustment for baseline differences did not remove this difference (odds ratio 1.42, 95% confidence interval 1.15 to 1.75). Adjustment for body surface area, an intrinsic gender difference, further attenuated the relationship (odds ratio 1.26, 95% confidence interval 0.96 to 1.64). Conclusions The 30-day mortality after CABG decreased significantly between 1991 and 2004, especially in women, suggesting that the gender difference in short-term outcomes is diminishing. The overall 42% higher mortality risk in women seems to be partially mediated through body surface area, a surrogate for vessel size.
Sex differences in coronary artery bypass grafting-related morbidity and mortality
Frontiers in Cardiovascular Medicine
BackgroundCoronary artery bypass grafting (CABG) is associated with both cardiovascular disease (CVD) and non-CVD traits. In addition, women’s prognosis after coronary events and revascularizations is worse than in men. As the course of CVD in women differs from that of men, we performed a phenome-wide analysis on the sex differences in CABG -related morbidity and mortality.Materials and methodsWe performed an untargeted analysis on the sex differences in predictors and outcomes of CABG. We studied a sample of 176,680 FinnGen participants, including 5,950 individuals who underwent CABG (4,988 men and 962 women) and were followed between 1998 and 2019. Over 1,100 different traits were analyzed for both sexes and the results were adjusted with age, smoking status and BMI. Cox proportional hazards models with sex-trait interactions were used to estimate the associations between (1) traits and incident CABG; and (2) CABG and incident traits.ResultsIn women, CABG was more strongly relate...