Literature DB >> 18291164

Do women currently receive the same standard of care in coronary artery bypass graft procedures as men? A propensity analysis.

Alessandro Parolari1, Luca Dainese, Moreno Naliato, GianLuca Polvani, Claudia Loardi, Matteo Trezzi, Melissa Fusari, Cristina Beverini, Elena Tremoli, Paolo Biglioli, Francesco Alamanni.   

Abstract

BACKGROUND: The purpose of this study was to determine whether, in recent years, sex differences in the type of care during coronary artery bypass graft surgery procedures occurred.
METHODS: Between 1995 and 2004, 5,935 consecutive patients (4,867 men and 1,068 women) underwent isolated coronary artery bypass graft surgery; propensity score matching was used to investigate whether sex adversely impacts standard care and early outcomes of coronary revascularization.
RESULTS: Of the 1,068 women undergoing isolated coronary artery bypass graft surgery, only 280 (26.2%) were matched on propensity scores with men. Distribution of preoperative variables among matched pairs was, on average, equal. Propensity-matched women received similar number of distal anastomoses as men (2.70 +/- 0.89 versus 2.82 +/- 0.97; p = 0.13), had similar rates of complete revascularization (82.5% versus 81.6%; p = 0.78), and of off-pump procedures (24.3% versus 27.5%; p = 0.39); also, the rate of utilization of arterial grafts (left internal mammary artery 98.5% versus 98.2%; p = 0.73; right internal mammary artery 3.2% versus 3.2%; p > 0.99; radial artery 8.2% versus 9.6%; p = 0.55), as well as the number of distal anastomoses performed with arterial grafts (1.11 +/- 0.36 versus 1.13 +/- 0.39; p = 0.47), were similar in women and men. No differences were detected in major complications (in-hospital mortality, perioperative myocardial infarction, and stroke) in propensity-matched pairs, whereas women had lower reexploration for bleeding and blood transfusion rates.
CONCLUSIONS: The preoperative profiles of women and men were markedly different, as only one fourth of women could be matched. In the current era, after adjustment for preoperative variables, female patients received the same standard of care as men, with improved results in some minor early outcomes.

Entities:  

Mesh:

Year:  2008        PMID: 18291164     DOI: 10.1016/j.athoracsur.2007.11.022

Source DB:  PubMed          Journal:  Ann Thorac Surg        ISSN: 0003-4975            Impact factor:   4.330


  8 in total

Review 1.  Saphenous vein graft vs. radial artery graft searching for the best second coronary artery bypass graft.

Authors:  Hilal Ali Al-Sabti; Adil Al Kindi; Khalid Al-Rasadi; Yajnavalka Banerjee; Khamis Al-Hashmi; Ali Al-Hinai
Journal:  J Saudi Heart Assoc       Date:  2013-10

2.  Practice Variation Among Hospitals in Revascularization Therapy and Its Association With Procedure-related Mortality.

Authors:  Jarrod E Dalton; David A Zidar; Belinda L Udeh; Manesh R Patel; Jesse D Schold; Neal V Dawson
Journal:  Med Care       Date:  2016-06       Impact factor: 2.983

3.  Impact of gender differences on hemostasis in patients after coronary artery bypass grafts surgeries in the context of tranexamic acid administration.

Authors:  Enshi Wang; Yang Wang; Shengshou Hu; Su Yuan
Journal:  J Cardiothorac Surg       Date:  2022-05-21       Impact factor: 1.522

4.  Are the Early Postoperative Outcomes of Coronary Artery Bypass Grafting Surgery in Elderly Women Worse Compared to Men's?

Authors:  Ahmet Yüksel; Irem Iris Kan; Atıf Yolgösteren; Yusuf Velioğlu; Mustafa Çagdaş Çayır; Orçun Gürbüz; Gencehan Kumtepe; Serkan Akarsu; Murat Biçer; Mustafa Tok; Işık Şenkaya
Journal:  Braz J Cardiovasc Surg       Date:  2017 May-Jun

5.  Coronary surgery in women: How can we improve outcomes.

Authors:  Brittany A Zwischenberger; Oliver K Jawitz; Jennifer S Lawton
Journal:  JTCVS Tech       Date:  2021-10-02

6.  Does prior coronary artery bypass surgery alter the gender gap in patients presenting with acute coronary syndrome? A 20-year retrospective cohort study.

Authors:  Rafid Fayadh Al-Aqeedi; Jassim Al Suwaidi; Rajvir Singh; Hajar A Al Binali
Journal:  BMJ Open       Date:  2012-11-28       Impact factor: 2.692

7.  Early and Mid-term Outcomes in Female Patients Undergoing Isolated Conventional Coronary Surgery.

Authors:  Kazim Erguneş; Levent Yilik; Ufuk Yetkin; Banu Lafcı; Serdar Bayrak; Berkan Ozpak; Ali Gurbuz
Journal:  J Cardiovasc Thorac Res       Date:  2014-06-30

8.  Coronary Artery Bypass Grafting in Women 50 Years or Younger.

Authors:  Magnus Dalén; Susanne Nielsen; Torbjörn Ivert; Martin J Holzmann; Ulrik Sartipy
Journal:  J Am Heart Assoc       Date:  2019-09-14       Impact factor: 5.501

  8 in total

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