Do women currently receive the same standard of care in coronary artery bypass graft procedures as men? A propensity analysis.
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.
Parolari
Alessandro
A
Department of Cardiac Surgery, Unit for Clinical Research in Atherothrombosis, Centro Cardiologico Monzino IRCCS, Milan, Italy. alessandro.parolari@cardiologicomonzino.it
Dainese
Luca
L
Naliato
Moreno
M
Polvani
GianLuca
G
Loardi
Claudia
C
Trezzi
Matteo
M
Fusari
Melissa
M
Beverini
Cristina
C
Tremoli
Elena
E
Biglioli
Paolo
P
Alamanni
Francesco
F
D000368:Aged; D001026:Coronary Artery Bypass / Q000592:standards* / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012737:Sex Factors