Early results of coronary artery bypass graft surgery in women.
BACKGROUND
Coronary artery disease is one of the leading causes of death among women in developed countries all over the world. Coronary artery bypass grafting (CABG) is a well established therapeutic modality to treat diffuse coronary artery atherosclerosis.


OBJECTIVE
In this study we focused on the retrospective assessment of the early results of CABG in women as compared to the results of such treatment in men.


METHODS
This analysis involved 2881 patients (677 women and 2204 men) who underwent CABG between 2003 and 2005. An operative technique (conventional on-pump or off-pump) was applied in a similar proportion of patients in both groups (on-pump: 59.4% of women and 59.6% of men; NS). Women were older than men and had higher body mass index. Concomitant disorders such as diabetes mellitus, hypertension and hypercholesterolaemia were noted more frequently in female patients.


RESULTS
In the perioperative period, left ventricular failure requiring intra-aortic balloon pump insertion and administration of high doses of catecholamines was observed significantly more often in women than in men (22.1 vs. 16.1%, respectively; p <0.001). Perioperative myocardial infarction was diagnosed more frequently in women (5.5 vs. 2.9%; p <0.001). In female patients, the rate of repeat operation was higher (8.9 versus 5.1%; p <0.001) and more subjects required blood transfusions (45.5 vs. 27.5%; p <0.001). Female gender featured a higher rate of postoperative acute renal failure requiring renal replacement therapy (8.5 vs. 0.95%; p <0.001). Mechanical ventilation was longer, and women stayed longer in the postoperative intensive care unit as well as in hospital. Early postoperative mortality among women was 3.6%, i.e. significantly higher than in male patients (1.6%) (p <0.01).


CONCLUSIONS
The analysis performed herein suggests that mortality and morbidity after CABG is higher in women than in men.
Czech
Bronisław
B
Department of Cardiac Surgery and Transplantology, Silesian Center for Heart Diseases, Medical University of Silesia, ul. Szpitalna 2, 41-800 Zabrze, Poland.
Kucewicz-Czech
Ewa
E
Pacholewicz
Jerzy
J
Wojarski
Jacek
J
Puzio
Jacek
J
Przybylski
Roman
R
Farmas
Arkadiusz
A
Ryfiński
Bogdan
B
Zembala
Marian
M
D058186:Acute Kidney Injury / Q000401:mortality; D016063:Blood Loss, Surgical / Q000401:mortality; D015897:Comorbidity; D001026:Coronary Artery Bypass; D003324:Coronary Artery Disease / Q000401:mortality* / Q000601:surgery*; D003920:Diabetes Mellitus / Q000453:epidemiology; D005260:Female; D006801:Humans; D006937:Hypercholesterolemia / Q000453:epidemiology; D006973:Hypertension / Q000453:epidemiology; D007423:Intra-Aortic Balloon Pumping / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000401:mortality; D011183:Postoperative Complications / Q000401:mortality*; D012189:Retrospective Studies; D012737:Sex Factors; D016896:Treatment Outcome; D018487:Ventricular Dysfunction, Left / Q000401:mortality