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Observational Study
. 2025 Apr;122(5):e20240664.
doi: 10.36660/abc.20240664.

Is Female Gender Associated with Mortality in Coronary Artery Bypass Grafting?

[Article in Portuguese, English]
Maxim Goncharov  1 , Erlon Oliveira de Abreu Silva  1 , Pedro Gabriel Melo de Barros E Silva  1 , Fabiane Letícia de Freitas  2 , Adriana Costa Moreira  1 , Lucas Tramujas  1 , Alexandre Biasi Cavalcanti  1 , Ieda Maria Liguori  1 , Fabio Biscegli Jatene  2 , Ieda Biscegli Jatene  1 , Claudia Maria Rodrigues Alves  1
Affiliations
Observational Study

Is Female Gender Associated with Mortality in Coronary Artery Bypass Grafting?

[Article in Portuguese, English]
Maxim Goncharov et al. Arq Bras Cardiol. 2025 Apr.

Abstract
in English, Portuguese

Background: Women undergoing coronary artery bypass grafting (CABG) tend to have worse in-hospital outcomes, but it is unclear whether these differences are due to gender or to clinical factors.

Objective: To compare in-hospital outcomes between women and men undergoing CABG.

Methods: This was a single-center, retrospective observational study analyzing data from 9,845 patients who underwent CABG between 1995 and 2022, of whom 1,947 (19.8%) were women. To evaluate female gender as a prognostic factor for in-hospital mortality, we used descriptive statistics, univariate and multivariate logistic regression, and propensity score matching. The significance level was set at 5%.

Results: Women were older (66.7 vs 62.19 years, p<0.001), had lower body mass index (26.91 vs 27.64, p<0.001), and had a higher prevalence of diabetes mellitus (34.0% vs 31.6%, p=0.045). They also had longer hospital stays (14.84 vs 13.13 days, p<0.001) and higher operative mortality (4.8% vs 2.4%, p<0.001). In logistic regression, female gender was associated with higher mortality (OR=1.51; 95% CI: 1.15-1.99; p=0.003). After matching, there was no significant difference in mortality (OR=1.20; 95% CI: 0.88-1.64; p=0.241), but length of hospital stay remained longer in women.

Conclusion: When clinical factors were matched between men and women, the mortality difference disappeared. This suggests that targeted interventions to reduce disparities may help improve mortality outcomes in women undergoing CABG.

Fundamento: Mulheres submetidas à cirurgia de revascularização do miocárdio (CRM) apresentam piores desfechos intra-hospitalares, mas não está claro se essas diferenças são atribuídas ao sexo ou a fatores clínicos.

Objetivo: Comparar os desfechos intra-hospitalares entre mulheres e homens submetidos à CRM.

Métodos: Este estudo observacional, unicêntrico e retrospectivo analisou dados de 9.845 pacientes submetidos à CRM entre 1995 e 2022; dentre eles, 1.947 (19,8%) eram mulheres. Para avaliar o sexo feminino como fator prognóstico de mortalidade intra-hospitalar, foram realizadas análises estatísticas descritivas, regressões logísticas univariada e multivariada e pareamento por escore de propensão. O nível de significância foi estabelecido em 5%.

Resultados: Mulheres apresentaram maior idade (66,7 vs 62,19 anos, p<0,001), menor índice de massa corporal (26,91 vs 27,64, p<0,001) e maior prevalência de diabetes melito (34,0% vs 31,6%, p=0,045). Elas também tiveram maior tempo de internação (14,84 vs 13,13 dias, p<0,001) e maior mortalidade operatória (4,8% vs 2,4%, p<0,001). Após regressão logística, o sexo feminino foi associado à maior mortalidade (OR: 1,51, IC 95%: 1,15-1,99, p=0,003). Após o pareamento, não houve diferença significativa na mortalidade (OR: 1,20, IC 95%: 0,88-1,64, p=0,241), porém o tempo de internação permaneceu maior entre as mulheres.

Conclusão: Ao se igualarem os fatores clínicos entre homens e mulheres por meio do pareamento, as diferenças na mortalidade desaparecem. Isso sugere que intervenções voltadas à redução das disparidades podem ser eficazes para melhorar os desfechos de mortalidade em mulheres submetidas à CRM.

PubMed Disclaimer

Conflict of interest statement

Potencial conflito de interesse: Não há conflito com o presente artigo

Figures

Figura Central:
Figura Central:. O Sexo Feminino está Associado à Mortalidade na Cirurgia de Revascularização do Miocárdio?
Figura 1
Figura 1. – Fluxograma de seleção de pacientes para inclusão no estudo. CRM: cirurgia de revascularização do miocárdio.
Central Illustration:
Central Illustration:. Is Female Gender Associated with Mortality in Coronary Artery Bypass Grafting?
Figure 1
Figure 1. – Flowchart of patient selection for inclusion in the study. CABG: coronary artery bypass grafting.
See this image and copyright information in PMC

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