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Published on: March 27, 2018
Sex-related differences in long-term mortality after coronary artery bypass graft surgery: A systematic review and
David T Zhang1, Simrat Dhaliwal1, Navindra Tajeshwar2
1Division of Cardiology, Department of Medicine, Stony Brook Medicine, Stony Brook, NY, USA.
Insights
Women face higher long-term mortality risks after coronary artery bypass graft (CABG) surgery compared to men. This comprehensive meta-analysis highlights significant sex-related differences in post-CABG survival rates.
Area of Science:
- Cardiovascular Surgery
- Medical Statistics
- Health Outcomes Research
Background:
- Coronary artery bypass graft (CABG) surgery is a common intervention for coronary artery disease.
- Understanding sex-specific outcomes after CABG is crucial for personalized patient care.
- Previous studies have suggested potential differences in long-term survival between men and women undergoing CABG.
Purpose of the Study:
- To conduct a meta-analysis evaluating sex-related differences in long-term mortality (≥7 years) following CABG.
- To determine if female sex is associated with increased long-term mortality after CABG surgery.
- To provide robust evidence on sex disparities in CABG outcomes.
Main Methods:
- A systematic literature search was performed across Ovid MEDLINE, Embase, and Web of Science.
- Studies reporting sex-specific mortality data after CABG were included, irrespective of publication date or status.
- Long-term mortality, defined as ≥7 years post-CABG, was the primary endpoint of interest.
Main Results:
- The meta-analysis included 19 studies encompassing 277,224 patients (60,858 women, 216,369 men).
- Women were, on average, older than men at the time of surgery (66.5 vs. 63.1 years).
- Female sex was significantly associated with higher long-term mortality following CABG (OR 1.17; 95% CI 1.05-1.30; p < 0.01).
Conclusions:
- Women experience higher long-term mortality rates after CABG compared to men.
- This study represents the largest meta-analysis to date investigating sex-specific long-term mortality after CABG.
- The findings underscore the need for further research into the underlying causes of these sex disparities and for tailored clinical management strategies.
Background:
This meta-analysis assessed the sex-related differences in long-term mortality (≥7 years) after coronary artery bypass graft (CABG) surgery.
Methods:
We searched the databases Ovid MEDLINE, Embase, and Web of Science for studies reporting sex-specific differences in mortality following CABG. The search was not restricted to time or publication status. The primary endpoint of interest was long-term mortality (≥7 year or longer).
Results:
A total of 1289 studies resulted from literature search. A total of 19 studies with 277,224 patients (60,858 women and 216,369 men) were included. The mean age was higher in women than men (66.5 vs. 63.1 years). Our analysis demonstrated that female sex was associated with higher long-term mortality (≥7 years) following CABG (odds ratio 1.17; 95% confidence interval 1.05-1.30; p < 0.01).
Conclusions:
Our results suggest that women had higher long-term mortality following CABG compared with men. It is the largest study to date of sex-specific differences in long-term mortality (≥7 years).
