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Sex-Based Outcomes After Coronary Artery Bypass Grafting




TekijätKytö Ville, Sipilä Jussi, Tornio Aleksi, Rautava Päivi, Gunn Jarmo

KustantajaElsevier Inc.

Julkaisuvuosi2021

JournalAnnals of Thoracic Surgery

Tietokannassa oleva lehden nimiAnnals of Thoracic Surgery

Vuosikerta112

Numero6

Aloitussivu1974

Lopetussivu1981

eISSN1552-6259

DOIhttps://doi.org/10.1016/j.athoracsur.2021.01.014


Tiivistelmä

Background

Sex is suggested to influence outcomes after coronary artery bypass grafting (CABG), although evidence on long-term mortality is controversial and cardiovascular outcome data are lacking. We studied sex differences in outcomes after isolated CABG.

Methods

Consecutive patients with first-time isolated CABG for stable coronary artery disease between 2004 and 2014 in Finland were retrospectively recognized from national registry (n = 14,681; 21% women). Propensity scoring and inverse probability weighting were used to adjust for baseline features. Median follow-up was 10.0 (maximum 14.6) years.

Results

Cumulative major adverse cardiovascular event (myocardial infarction, stroke, or cardiovascular death) rate was 44.5% in men and 49.9% in women during follow-up (hazard ratio [HR], 0.98; P = .633). All-cause mortality was 48.5% in men vs 46.0% in women (HR, 1.20; 95% confidence interval, 1.11-1.30; P < .0001), and cardiovascular mortality was 29.5% vs 31.3% (P = .625). Stroke rate was comparable between men and women (19.4% vs 23.6%; P = .625). Myocardial infarction occurred more frequently in women (20.0% vs 23.6%; HR, 0.84; 95% confidence interval, 0.75-0.95; P = .005). Redo revascularization was performed to 12.8% of women and to 12.6% of men (P = .100). Anticoagulation was more frequently used by men and adenosine diphosphate inhibitors and diuretics were more frequently used by women after CABG. Usage of statins, angiotensin-converting-enzyme inhibitors or angiotensin-blockers, beta-blockers, calcium-channel blockers, or nitrates did not differ between sexes after CABG.

Conclusions

Sex was not an independent predictor of long-term major adverse cardiovascular events after CABG in this population-based cohort study. However, men had higher long-term all-cause mortality and women higher risk of myocardial infarction. Long-term outcomes should be accounted for when considering sex as a risk factor for CABG.



Last updated on 2024-26-11 at 22:54