Marital status and timing of coronary artery surgery

Women undergoing surgery for coronary artery disease are older and have greater impairment of functional status than their male counterparts, suggesting either gender differences or gender bias. Reduced willingness to accept risks of surgery and reduced reliability of non-invasive tests in women have been proposed as possible explanations of surgical intervention delay. Since women survive their husbands by 7 years, their role as a terminal caretaker may impede acceptance of recommended surgery. In a record review of 145 women who underwent coronary artery bypass surgery, widows, as compared with the general population, were over-represented in each of the 3 decades from age 45-74. A prospective study to assess the several variables contributing to poorer surgical outcome in women is warranted.