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Published on: March 27, 2018
Sex-Specific Differences in Early Occlusion Rate After Coronary Artery Bypass Grafting
Luca Koechlin1, Islam Salikhanov2, Brigitta Gahl3
1Department of Cardiac Surgery, University Hospital Basel, University of Basel, Basel, Switzerland; Cardiovascular Research Institute Basel (CRIB) and Department of Cardiology, University Hospital Basel, Basel, Switzerland.
Insights
Female patients undergoing coronary artery bypass grafting (CABG) experienced higher rates of early bypass graft occlusion. This finding highlights potential sex-based disparities in CABG outcomes, warranting further investigation into underlying mechanisms.
Area of Science:
- Cardiovascular Surgery
- Medical Imaging
- Health Outcomes Research
Background:
- Coronary artery bypass grafting (CABG) is a common procedure to treat coronary artery disease.
- Early graft occlusion is a significant complication following CABG.
- Existing research has not fully elucidated potential sex differences in early bypass graft occlusion rates.
Purpose of the Study:
- To investigate whether there is a difference in early bypass graft occlusion rates after CABG between male and female patients.
- To assess the association between female sex and the risk of bypass graft occlusion.
- To evaluate the impact of early graft occlusion on subsequent clinical outcomes.
Main Methods:
- A consecutive series of adult patients undergoing isolated CABG were included in the study.
- Bypass graft patency was evaluated using postoperative computed tomography (CT) scans before hospital discharge.
- Follow-up data on mortality, major adverse cardiac and cerebrovascular events, rehospitalizations, and cardiac reinterventions were collected.
Main Results:
- The study included 589 patients, with 16% being women. Early bypass graft occlusion was detected in 7.6% of patients.
- Female patients exhibited significantly higher rates of bypass graft occlusion (14% vs 6.5%, P = .02).
- Female sex was independently associated with increased odds of graft occlusion (OR, 2.6; P = .02). Patients with occluded grafts had higher rates of rehospitalization and reintervention, but no sex differences in follow-up outcomes were observed.
Conclusions:
- Early bypass graft occlusion after isolated CABG occurs significantly more frequently in female patients compared to male patients.
- Standardized postoperative CT scans are effective in detecting early graft occlusion before discharge.
- The findings suggest a potential sex-based disparity in early graft patency following CABG.
Background:
This study assessed whether there is a difference in early bypass graft occlusion rates after coronary artery bypass grafting (CABG) between men and women.
Methods:
Consecutive adult patients undergoing isolated CABG surgery were included. Bypass graft patency was assessed in a postoperative electrocardiogram-gated coronary bypass computed tomography heart scan before discharge. Follow-up data included mortality, major adverse cardiac and cerebrovascular events, rehospitalizations, and cardiac reinterventions.
Results:
The study included 589 patients (mean, 67 years; SD, 9.4 years), of whom 95 (16%) were women. Bypass graft occlusion was detected in 45 of 589 patients (7.6%) and was seen significantly more often in female patients compared with male patients (n = 13 [14%] vs n = 32 [6.5%], P = .02). This resulted in 14 of 292 (4.8%) and 35 of 1690 (2.1%) occluded grafts (P < .01), respectively. Female sex was significantly associated with higher odds of graft occlusion (odds ratio, 2.6; 95% CI, 1.1-5.7; P = .02). During the median follow-up of 14.5 months (interquartile range, 13.3-16.5 months) in 292 patients, overall mortality was 3.1% (n = 9), with higher incidence of rehospitalizations (28% vs 4.1%, P = .01) and reinterventions (28% vs 2.6%, P < .01) observed in patients with occluded grafts. No statistically significant differences in follow-up outcomes were observed between male and female patients.
Conclusions:
Early bypass graft occlusion, detected through standardized postoperative computed tomography scans before discharge, occurred significantly more frequently in female patients compared with male patients after isolated CABG surgery.
