Health status after myocardial revascularization: inferior results in women

Abstract

We followed up 1,335 patients (287 female, 1,048 male) for 2 to 18 years (mean, 4.3 years) after they had undergone coronary artery bypass grafting. A health status index was calculated on the basis of their responses to annual questionnaires. The female patients were older (64.1 +/- 0.3 versus 60.4 +/- 0.3 years) and had a higher incidence of diabetes (28.6% versus 16.1%). The risk profile of women was otherwise similar to that of men. The hospital mortality was significantly higher in the women, particularly in those younger than age 60. The probability of survival (Kaplan-Meier) at 5, 10, and 15 years was lower in female patients at each interval. The mean health status index was also lower in women at 5, 10, and 15 years, and also lower in all subsets. In nondiabetic patients, the hospital mortality and probability of survival at 10 years did not differ between the female and male patients. In the diabetic patients, the hospital mortality was 11.0% (women) and 3.6% (men); the survival at 10 years was 0.42 (women) and 0.56 (men) (p < 0.001). Thus, the health status in women is less satisfactory than that of men after myocardial revascularization, and the probability of survival is lower. The excess mortality in female patients may be due to the higher incidence of diabetes in this group.