Effect of female gender on the outcome of coronary artery bypass surgery for left main coronary artery disease.
OBJECTIVE
Early mortality after coronary artery bypass grafting is generally higher in women than in men. This study analyzes the effect of female gender on early mortality of coronary artery bypass grafting particularly for left main coronary artery disease.


METHODS
Study population consisted of 144 consecutive patients (33 women, 111 men) undergoing coronary artery bypass grafting for left main coronary artery disease. Mean follow-up was 25.1 +/- 14.0 months. Data were collected retrospectively and presented as mean +/- standard deviation. Survival analysis was done using Kaplan-Meier actuarial curve method with the log rank univariate test, followed by Cox's proportional rate multivariate model.


RESULTS
Overall mortality was 7% in the patient population. Cox regression analysis revealed that the independent predictors of increased total mortality were female gender (HR 8.34, 95% CI 1.79 - 38.76, p=0.007), advanced age (HR 1.12, 95% CI 1.02-1.23, p=0.014), degree of left main coronary artery stenosis (HR 1.068, 95%CI 1.005-1.135, p=0.03), and left ventricular ejection fraction (HR 0.93, 95% CI 0.87-0.99, p=0.03). Female gender was found to be the only independent predictor of increased early mortality (HR 13.18, 95%CI 1.444-120.343, p=0.02). After discharge from the hospital, female gender was no more a predictor of increased mortality.


CONCLUSIONS
According to these data, we may assume that female gender is related with increased mortality in coronary artery surgery for left main disease in the pre-discharge period however after discharge from hospital, long-term benefit of female survivors of coronary artery bypass grafting operated on for left main coronary artery disease might be as good as in men.
Katircibaşi
M Tuna
MT
Department of Cardiology, School of Medicine, Başkent University, Ankara, Adana, Turkey. mtuna89@yahoo.com
Koçum
H Tolga
HT
Baltali
Mehmet
M
Erol
Tansel
T
Tekin
Abdullah
A
Yiğit
Fatma
F
Tekin
Göknur
G
Kiziltan
H Tarik
HT
Müderrisoğlu
Haldun
H
D001026:Coronary Artery Bypass / Q000401:mortality*; D003324:Coronary Artery Disease / Q000473:pathology / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D008499:Medical Records; D008875:Middle Aged; D010351:Patient Discharge / Q000706:statistics & numerical data; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D012737:Sex Factors; D016019:Survival Analysis; D016896:Treatment Outcome; D014421:Turkey / Q000453:epidemiology