Early results of coronary artery bypass graft surgery in women

Abstract

Background: Coronary artery disease is one of the leading causes of death among women in developed countries all over the world. Coronary artery bypass grafting (CABG) is a well established therapeutic modality to treat diffuse coronary artery atherosclerosis.

Aim: In this study we focused on the retrospective assessment of the early results of CABG in women as compared to the results of such treatment in men.

Methods: This analysis involved 2881 patients (677 women and 2204 men) who underwent CABG between 2003 and 2005. An operative technique (conventional on-pump or off-pump) was applied in a similar proportion of patients in both groups (on-pump: 59.4% of women and 59.6% of men; NS). Women were older than men and had higher body mass index. Concomitant disorders such as diabetes mellitus, hypertension and hypercholesterolaemia were noted more frequently in female patients.

Results: In the perioperative period, left ventricular failure requiring intra-aortic balloon pump insertion and administration of high doses of catecholamines was observed significantly more often in women than in men (22.1 vs. 16.1%, respectively; p <0.001). Perioperative myocardial infarction was diagnosed more frequently in women (5.5 vs. 2.9%; p <0.001). In female patients, the rate of repeat operation was higher (8.9 versus 5.1%; p <0.001) and more subjects required blood transfusions (45.5 vs. 27.5%; p <0.001). Female gender featured a higher rate of postoperative acute renal failure requiring renal replacement therapy (8.5 vs. 0.95%; p <0.001). Mechanical ventilation was longer, and women stayed longer in the postoperative intensive care unit as well as in hospital. Early postoperative mortality among women was 3.6%, i.e. significantly higher than in male patients (1.6%) (p <0.01).

Conclusions: The analysis performed herein suggests that mortality and morbidity after CABG is higher in women than in men.