title: Increased coronary artery disease severity in black women undergoing coronary bypass surgery.
abstract: Race and sex disparities are believed to play an important role in heart disease. The purpose of this study was to examine the association between race, sex, and number of diseased vessels at the time of coronary artery bypass grafting (CABG), and subsequent postoperative outcomes. The 13,774 patients undergoing first-time, isolated CABG between 1992 and 2011 were included. Trend in the number of diseased vessels between black and white patients, stratified by sex, were analyzed using a Cochran-Armitage trend test. Models were adjusted for age, procedural status (elective vs. nonelective), and payor type (private vs. nonprivate insurance). Black female CABG patients presented with an increasingly greater number of diseased vessels than white female CABG patients (adjusted P(trend) = 0.0021). A similar trend was not observed between black and white male CABG patients (adjusted P(trend) = 0.18). Black female CABG patients were also more likely to have longer intensive care unit and hospital lengths of stay than other race-sex groups.Our findings suggest that black female CABG patients have more advanced coronary artery disease than white female CABG patients. Further research is needed to determine the benefit of targeted preventive care and preoperative workup for this high-risk group.
authors.affiliation: From the Department of Cardiovascular Sciences (JTE, WFG, KYS, LCK, TBF, WRC, APK), East Carolina Heart Institute; Center for Health Disparities (JTE, HL), Brody School of Medicine, East Carolina University, Greenville; Department of Internal Medicine (WTO), Wake Forest School of Medicine, Winston-Salem; Department of Pharmacology and Toxicology (EJA), Brody School of Medicine, East Carolina University, Greenville, North Carolina; Department of General Surgery (SWD), University of Virginia School of Medicine, Charlottesville, Virginia; and Department of Anesthesia (JBO), Critical Care, and Pain Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts.
authors.forename: Jimmy T
authors.initials: JT
authors.lastname: Efird
authors.forename: Wesley T
authors.initials: WT
authors.lastname: O'Neal
authors.forename: William F
authors.initials: WF
authors.lastname: Griffin
authors.forename: Ethan J
authors.initials: EJ
authors.lastname: Anderson
authors.forename: Stephen W
authors.initials: SW
authors.lastname: Davies
authors.forename: Hope
authors.initials: H
authors.lastname: Landrine
authors.forename: Jason B
authors.initials: JB
authors.lastname: O'Neal
authors.forename: Kristin Y
authors.initials: KY
authors.lastname: Shiue
authors.forename: Linda C
authors.initials: LC
authors.lastname: Kindell
authors.forename: T
authors.initials: T
authors.lastname: Bruce Ferguson
authors.forename: W
authors.initials: W
authors.lastname: Randolph Chitwood
authors.forename: Alan P
authors.initials: AP
authors.lastname: Kypson
mesh_terms: D001741:Black or African American; D000368:Aged; D000369:Aged, 80 and over; D001026:Coronary Artery Bypass / Q000706:statistics & numerical data*; D003324:Coronary Artery Disease / Q000208:ethnology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012720:Severity of Illness Index; D012737:Sex Factors; D044465:White People