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

J Cardiothorac Vasc Anesth. 2022 May;36(5):1288-1295. doi: 10.1053/j.jvca.2021.08.104. Epub 2021 Sep 5.

Abstract

Objectives: Women undergoing coronary artery bypass grafting (CABG) demonstrate higher rates of postoperative morbidity and mortality than men. The aim of this study was to compare the patient profile and long-term outcomes of men and women undergoing isolated CABG.

Design: A retrospective patient record study and propensity score-matched analysis.

Setting: This single-center study was performed at Catharina Hospital in Eindhoven, The Netherlands.

Participants: The study comprised 17,483 patients, of whom 13,564 (77.6%) were men and 3,919 (22.4%) were women.

Interventions: Coronary artery bypass grafting was performed between January 1998 and December 2015.

Measurements and main results: The mean follow-up period was 8.8 ± 5.0 years. Women were older than men (67.7 ± 9.4 years v 63.9 ± 9.6 years, p < 0.001) and had lower preoperative hemoglobin levels. Early mortality (30-day) (2.8% v 1.9%; p < 0.001) and one-year mortality (5.2% v 3.8%; p < 0.001) rates were significantly higher in women than in men. Women demonstrated worse long-term survival than men only in the population younger than 70 years. After propensity score matching, female sex was not identified as an independent risk factor for long-term survival.

Conclusions: In the patient population, propensity score-matched analysis showed that female sex was not an independent risk factor for long-term survival after CABG. Poorer survival in women after CABG only was observed in patients <70 years of age.

Keywords: coronary artery bypass grafting; propensity score matching; sex; survival analysis.

MeSH terms

  • Coronary Artery Bypass / adverse effects
  • Coronary Artery Disease* / surgery
  • Female
  • Follow-Up Studies
  • Humans
  • Male
  • Propensity Score
  • Retrospective Studies
  • Risk Factors
  • Sex Characteristics*
  • Survival Rate
  • Treatment Outcome