Sex-Based Outcomes After Coronary Artery Bypass Grafting

被引:8
|
作者
Kyto, Ville
Sipila, Jussi
Tornio, Aleksi
Rautava, Paivi
Gunn, Jarmo
机构
[1] Univ Turku, Turku Univ Hosp, Heart Ctr, Turku, Finland
[2] Univ Turku, Res Ctr Appl & Prevent Cardiovasc Med, Turku, Finland
[3] Univ Turku, Turku Univ Hosp, Ctr Populat Hlth Res, Turku, Finland
[4] Hosp Dist Southwest Finland, Adm Ctr, Turku, Finland
[5] North Karelia Cent Hosp, Dept Neurol, Joensuu, Finland
[6] Univ Turku, Dept Neurol, Turku, Finland
[7] Univ Turku, Integrat Physiol & Pharmacol, Inst Biomed, Turku, Finland
[8] Turku Univ Hosp, Unit Clin Pharmacol, Turku, Finland
[9] Univ Turku, Dept Publ Hlth, Turku, Finland
[10] Turku Univ Hosp, Turku Clin Res Ctr, Turku, Finland
[11] Univ Turku, Dept Surg, Turku, Finland
来源
ANNALS OF THORACIC SURGERY | 2021年 / 112卷 / 06期
关键词
LONG-TERM MORTALITY; GENDER-DIFFERENCES; HOSPITAL DISCHARGE; WOMEN; SURVIVAL; MEN; AGE; QUALITY; DISEASE; IMPACT;
D O I
10.1016/j.athoracsur.2021.01.014
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
BACKGROUND Sex is suggested to influence outcomes after coronary artery bypass grafting (CABG), although evi-dence 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 in-verse 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). Anti-coagulation 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. (Ann Thorac Surg 2021;112:1974-82) (c) 2021 by The Society of Thoracic Surgeons
引用
收藏
页码:1974 / 1981
页数:8
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