title: The effect of patient sex on survival in patients undergoing isolated coronary artery bypass surgery receiving a radial artery.
abstract: OBJECTIVE
  To determine whether patient sex makes a difference to in-hospital mortality and survival in patients undergoing isolated coronary artery bypass graft surgery (CABG) receiving a radial artery graft.
  
  
  METHODS
  Analysis of consecutive patients on a validated prospective cardiac surgery database was performed for patients undergoing isolated CABG. Uni- and multivariate analyses were performed for in-hospital mortality and long-term survival. A propensity analysis was also performed.
  
  
  RESULTS
  Overall mortality was 2.1% (n = 284) for all cases, n = 13 369. Median follow-up was 7.0 (interquartile range 4.1-10.1) years. Of the cases 28.2% of males (n = 384) and 29.7% of females (n = 764) had a radial artery utilized. Univariate analysis demonstrated that in-hospital mortality was significantly lower in male patients, P < 0.001, and radial artery use was associated with increased survival in males, P < 0.0001, but not in females, P = 0.82. In male patients, multivariate analysis failed to identify the radial artery as a risk factor for in-hospital death. The radial artery was identified as a significant prognostic factor, associated with improved long-term survival (hazard ratio [HR] 0.78, 95% confidence interval [CI] 0.69-0.88, P = 0.0001). Propensity analysis confirmed this finding (HR 0.76, 95% CI 0.67-0.86, P < 0.0001). In female patients, multivariate analysis failed to identify the radial artery as a significant factor determining in-hospital mortality or long-term survival. Propensity analysis confirmed these findings.
  
  
  CONCLUSIONS
  Males derive a significant survival advantage if they receive a radial artery graft when undergoing isolated CABG. The radial artery makes no difference to long-term survival in female patients. Radial artery use does not affect in-hospital mortality regardless of patient sex.
authors.affiliation: Liverpool Heart and Chest Hospital, Liverpool, UK.
authors.forename: Mark
authors.initials: M
authors.lastname: Pullan
authors.affiliation: Liverpool Heart and Chest Hospital, Liverpool, UK.
authors.forename: Bilal H
authors.initials: BH
authors.lastname: Kirmani
authors.affiliation: Liverpool Heart and Chest Hospital, Liverpool, UK.
authors.forename: Thomas
authors.initials: T
authors.lastname: Conley
authors.affiliation: Liverpool Heart and Chest Hospital, Liverpool, UK.
authors.forename: Aung
authors.initials: A
authors.lastname: Oo
authors.affiliation: Liverpool Heart and Chest Hospital, Liverpool, UK.
authors.forename: Matthew
authors.initials: M
authors.lastname: Shaw
authors.affiliation: Liverpool Heart and Chest Hospital, Liverpool, UK.
authors.forename: James
authors.initials: J
authors.lastname: McShane
authors.affiliation: Liverpool Heart and Chest Hospital, Liverpool, UK mpoullis@hotmail.com.
authors.forename: Michael
authors.initials: M
authors.lastname: Poullis
mesh_terms: D000368:Aged; D000704:Analysis of Variance; D001026:Coronary Artery Bypass / Q000009:adverse effects / Q000401:mortality* / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D008297:Male; D008323:Mammary Arteries / Q000637:transplantation; D008875:Middle Aged; D015999:Multivariate Analysis; D057216:Propensity Score; D017534:Radial Artery / Q000637:transplantation*; D012737:Sex Factors
keywords: Coronary; Mortality; Patient sex; Radial artery; Survival