Sex Difference in Long-Term Survival After Coronary Artery Bypass Grafting Is Age-Dependent

Area of Science:

• Cardiovascular Surgery
• Surgical Outcomes
• Gender Disparities in Medicine

Background:

• Coronary artery bypass grafting (CABG) is a common cardiac procedure.
• Women undergoing CABG historically show higher postoperative morbidity and mortality rates compared to men.
• Understanding gender-specific outcomes in CABG is crucial for optimizing patient care.

Purpose of the Study:

• To compare the patient profile and long-term outcomes of men and women undergoing isolated CABG.
• To investigate potential gender-based differences in survival after CABG.
• To identify risk factors affecting long-term survival in female CABG patients.

Main Methods:

• Retrospective analysis of patient records from a single center (Catharina Hospital, Eindhoven, The Netherlands).
• Inclusion of 17,483 patients who underwent isolated CABG between January 1998 and December 2015.
• Propensity score-matched analysis to control for baseline differences between male and female patients.

Main Results:

• Women were older and had lower preoperative hemoglobin levels than men.
• Significantly higher early (30-day) and one-year mortality rates were observed in women.
• After propensity score matching, female sex was not an independent predictor of long-term survival, except in patients younger than 70 years.

Conclusions:

• Female sex is not an independent risk factor for long-term survival after CABG when adjusted for other factors.
• Poorer long-term survival in women post-CABG was primarily observed in the younger patient cohort (<70 years).
• Further research may explore specific factors contributing to observed differences in younger female patients.