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Open Access 01-12-2016 | Research article

Gender differences in outcomes following isolated coronary artery bypass grafting: long-term results

Authors: Francesco Nicolini, Antonella Vezzani, Daniela Fortuna, Giovanni Andrea Contini, Davide Pacini, Davide Gabbieri, Claudio Zussa, Rossana De Palma, Tiziano Gherli, RERIC (Registro dell’Emilia Romagna degli Interventi Cardiochirurgici) Investigators

Published in: Journal of Cardiothoracic Surgery | Issue 1/2016

Abstract

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.

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Title: Gender differences in outcomes following isolated coronary artery bypass grafting: long-term results
Authors: Francesco Nicolini
Antonella Vezzani
Daniela Fortuna
Giovanni Andrea Contini
Davide Pacini
Davide Gabbieri
Claudio Zussa
Rossana De Palma
Tiziano Gherli
RERIC (Registro dell’Emilia Romagna degli Interventi Cardiochirurgici) Investigators
Publication date: 01-12-2016
Publisher: BioMed Central
Published in: Journal of Cardiothoracic Surgery / Issue 1/2016
Electronic ISSN: 1749-8090
DOI: https://doi.org/10.1186/s13019-016-0538-4

At a glance: The STEP trials

Springer Medicine

Gender differences in outcomes following isolated coronary artery bypass grafting: long-term results

Abstract

Background

Methods

Results

Conclusions

At a glance: The STEP trials

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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