Comparison by meta-analysis of mortality after isolated coronary artery bypass grafting in women versus men

Mahboob Alam, Salman J. Bandeali, Waleed T. Kayani, Waqas Ahmad, Saima A. Shahzad, Hani Jneid, Yochai Birnbaum, Neal S. Kleiman, Joseph S. Coselli, Christie M. Ballantyne, Nasser Lakkis, Salim S. Virani

Research output: Contribution to journalArticle

49 Scopus citations

Abstract

Short- and long-term mortality in women who undergo coronary artery bypass grafting (CABG) has been evaluated in multiple studies with conflicting results. The investigators conducted a meta-analysis of all existing studies to evaluate the impact of female gender on mortality in patients who undergo isolated CABG. A comprehensive search of studies published through May 31, 2012 identified 20 studies comparing men and women who underwent isolated CABG. All-cause mortality was evaluated at short-term (postoperative period and/or at 30 days), midterm (1-year), and long-term (5-year) follow-up. Odds ratios (ORs) and 95% confidence interval (CIs) were calculated using a random-effects model. A total of 966,492 patients (688,709 men [71%], 277,783 women [29%]) were included in this meta-analysis. Women were more likely to be older; had significantly greater co-morbidities, including hypertension, diabetes mellitus, hyperlipidemia, unstable angina, congestive heart failure, and peripheral vascular disease; and were more likely to undergo urgent CABG (51% vs 44%, p <0.01). Short-term mortality (OR 1.77, 95% CI 1.67 to 1.88) was significantly higher in women. At midterm and long-term follow-up, mortality remained high in women compared with men. Women remained at increased risk for short-term mortality in 2 subgroup analyses including prospective studies (n = 41,500, OR 1.83, 95% CI 1.59 to 2.12) and propensity score-matched studies (n = 11,522, OR 1.36, 95% CI 1.04 to 1.78). In conclusion, women who underwent isolated CABG experienced higher mortality at short-term, midterm, and long-term follow-up compared with men. Mortality remained independently associated with female gender despite propensity score-matched analysis of outcomes.

Original languageEnglish (US)
Pages (from-to)309-317
Number of pages9
JournalAmerican Journal of Cardiology
Volume112
Issue number3
DOIs
StatePublished - Aug 1 2013

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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