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Vessel-sparing Excision and Primary Anastomosis
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Vessel-sparing Excision and Primary Anastomosis

Published on: January 7, 2019

Sex-related differences in outcome after high-risk vascular surgery after the administration of

Robina Matyal1, Feroze Mahmood, Peter Panzica

  • 1Department of Anesthesia and Critical Care and Pain Management, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA 02215, USA. rmatyal@bidmc.harvard.edu

Journal of Cardiothoracic and Vascular Anesthesia
|May 28, 2008
PubMed

Insights

Beta-blockers may protect men after vascular surgery, but this study found no benefit for women. High-risk women receiving beta-blockers had worse outcomes, particularly increased congestive heart failure.

Area of Science:

  • Cardiology
  • Vascular Surgery
  • Pharmacology

Background:

  • Beta-adrenergic-blocking medications are studied for cardioprotective effects in high-risk vascular surgery.
  • Previous research primarily focused on men, with limited data on women's response.

Purpose of the Study:

  • To investigate the efficacy of perioperative beta-blockade in women undergoing high-risk vascular surgery.
  • To compare outcomes between men and women receiving beta-blockers.

Main Methods:

  • Retrospective analysis of vascular surgery patients (infrainguinal focus).
  • Adverse outcomes included myocardial infarction, congestive heart failure (CHF), arrhythmia, renal failure, or death.
  • Compared outcomes based on perioperative beta-blockade administration in men and women, including beta-blocker-naïve and risk-stratified subsets. Logistic regression used for independent effect determination.

Main Results:

  • Beta-blockers reduced adverse outcomes in men (12.6% vs. 18.9%, p=0.04) but not in women (17.8% vs. 13.7%, p=0.37).
  • In beta-blocker-naïve patients, men showed reduced myocardial infarction and renal failure; women did not experience outcome reduction.
  • High-risk women receiving beta-blockers had worse outcomes (36.8% vs. 5.9%, p=0.02), primarily due to increased CHF.

Conclusions:

  • Perioperative beta-blockade did not demonstrate benefit for women in this retrospective analysis.
  • High-risk women may experience adverse effects, including increased congestive heart failure, when administered beta-blockers.
Abstract

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