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Indian Journal of Thoracic and Cardiovascular Surgery

06-09-2024 | CABG | Original Article

Long-term outcomes of women compared to men after off-pump coronary artery bypass grafting—a propensity-matched analysis

Authors: Anees Anwar, Varshini Subash, Rohik Micka Radhakrishnan, Neethu Krishna, Sheejamol Velickakathu Sukumaran, Rajesh Jose, Kirun Gopal, Praveen Kerala Varma

Published in: Indian Journal of Thoracic and Cardiovascular Surgery

Abstract

Background

Literature is not clear whether women experience increased mortality and adverse events after coronary artery bypass grafting (CABG). Studies have shown that women had comparative outcomes to men in off-pump CABG (OPCAB). Hence, we undertook this study to understand the short- and long-term outcomes of women compared to men after OPCAB.

Methods

Two thousand two hundred patients who underwent OPCAB from November 2014 to December 2021 were included in the study. Median follow-up period was 4.8 years. We performed propensity matching to match 404 women to 404 men.

Results

In the unmatched cohort, women had increased cardiovascular mortality and inferior major adverse cardiovascular and cerebral event (MACCE)–free survival. In the matched cohorts, there was no difference in the 30-day mortality, long-term survival, MACCE-free survival, and cardiovascular mortality between the sexes. Cox proportional hazard showed post-operative renal failure (p-value < 0.001; hazard ratio (HR) 11.469) (confidence interval (CI) 2.911–45.180), post-operative stroke (p-value 0.023, HR 6.473) (CI 1.295–32.356), EuroSCORE II > 6 (p-value 0.022, HR 3.561) (1.204–10.531), emergency surgery (p-value 0.022, HR 3.498) (CI 1.202–10.177), and ventilation hours (p-value 0.004, HR 3.327) (CI 1.455–7.607) were the risk factors associated with long-term mortality in women.

Conclusion

Our study showed that the increased risk profile of women was the reason for inferior MACCE-free survival and increased cardiovascular mortality in women in the long term after OPCAB. When the risk factors were matched, women had comparable outcomes to men.

Graphical Abstract

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Title: Long-term outcomes of women compared to men after off-pump coronary artery bypass grafting—a propensity-matched analysis
Authors: Anees Anwar
Varshini Subash
Rohik Micka Radhakrishnan
Neethu Krishna
Sheejamol Velickakathu Sukumaran
Rajesh Jose
Kirun Gopal
Praveen Kerala Varma
Publication date: 06-09-2024
Publisher: Springer Nature Singapore
Keywords: CABG
CABG
Published in: Indian Journal of Thoracic and Cardiovascular Surgery
Print ISSN: 0970-9134
Electronic ISSN: 0973-7723
DOI: https://doi.org/10.1007/s12055-024-01814-6

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Long-term outcomes of women compared to men after off-pump coronary artery bypass grafting—a propensity-matched analysis

Abstract

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