TY - JOUR
T1 - Association of gender with morbidity and mortality after isolated coronary artery bypass grafting. A propensity score matched analysis
AU - Alam, Mahboob
AU - Lee, Vei Vei
AU - Elayda, McArthur A.
AU - Shahzad, Saima A.
AU - Yang, Eric Y.
AU - Nambi, Vijay
AU - Jneid, Hani
AU - Pan, Wei
AU - Coulter, Stephanie
AU - Wilson, James M.
AU - Ramanathan, Kodangudi B.
AU - Ballantyne, Christie M.
AU - Virani, Salim S.
N1 - Funding Information:
All Disclosures: Dr. Virani is supported by a Department of Veterans Affairs Health Services Research and Development Service (HSR&D) Career Development Award ( CDA-09-028 ) and has received research support from Merck and National Football League Charities (all grants to the institution and not individual). Eric Yang, MD: Grant award funding from the American Heart Association South Central Affiliate Postdoctoral Fellowship program , NIH Clinical Research Loan Repayment Program, and from Gilead for an investigator-initiated research study on pulmonary hypertension. Dr. Nambi is supported by the NIH K-23 grant and reports research collaboration with GE , Medipattern , Tomtec , Gillson Longenbaugh and Gulf Coast Medical Foundation (all grants to the institution and not individual). Dr. Nambi is also working as a National monitor for a study sponsored by Anthera pharmaceuticals and has been on the advisory board for Roche. Dr. Christie M. Ballantyne reports following disclosures: Grant/Research Support (All paid to institution, not individual): Abbott , AstraZeneca , Bristol-Myers Squibb , GlaxoSmithKline , Genentech , Kowa , Merck, Novartis , Roche , Sanofi-Synthelabo , Takeda , NIH, ADA, AHA Consultant: Abbott, Adnexus, Amarin, Amylin, AstraZeneca, Bristol-Myers Squibb, Esperion, Genentech, GlaxoSmithKline, Idera Pharma, Kowa, Merck, Novartis, Omthera, Pfizer, Resverlogix, Roche, Sanofi-Synthelabo, Takeda. Speakers Bureau: Abbott, GlaxoSmithKline, Merck Honorarium: Abbott, Adnexus, Amarin, Amylin, AstraZeneca, Bristol-Myers Squibb, Esperion, Genentech, GlaxoSmithKline, Idera Pharma, Kowa, Merck, Novartis, Omthera, Resverlogix, Roche, Sanofi-Synthelabo, and Takeda.
PY - 2013/7/15
Y1 - 2013/7/15
N2 - Introduction: There is conflicting evidence about the impact of gender on outcomes after coronary artery bypass grafting (CABG). Methods: We performed a multivariate logistic regression and propensity score matched analyses in 13,115 patients (75% men) who underwent CABG between January 1, 1995 and December 31, 2009. The primary outcome was in-hospital mortality. Secondary outcomes included post-operative respiratory failure, stroke, myocardial infarction, sternal and leg wound infections, atrial fibrillation (AF), renal failure, need for postoperative intra-aortic balloon pump (IABP) support, and length of hospital stay. Results: A higher proportion of women (184; 5.6%) suffered in-hospital death compared to men (264; 2.7%), p < 0.0001. After propensity score matching (n = 3600 total, 1800 in each group), female gender was an independent predictor of mortality after isolated CABG (odds ratio [OR] = 1.84; 95% confidence interval [CI] 1.22-2.78). Women also experienced a higher incidence of postoperative complications including stroke (3.8% vs. 2.3%, OR 1.37; 95% CI 1.08-1.73) and leg wound infection (3.4% vs. 1.7%, OR 1.75; 95% CI 1.36-2.54) on multivariate regression analyses. However, these differences were not significant after propensity score matching. We also observed a lower risk of post-operative AF (21.2% vs. 22.1%, OR 0.78; 95% CI 0.70-0.86) in women that remained significant after propensity matching (O.R. 0.76; 95% C.I. 0.65-0.90). Length of hospital stay was longer in women compared with men (11.9 ± 9.0 vs. 10.4 ± 9.2 days, p < 0.0001). Conclusions: Female gender is an independent predictor of increased mortality and a lower incidence of post-operative AF after isolated CABG.
AB - Introduction: There is conflicting evidence about the impact of gender on outcomes after coronary artery bypass grafting (CABG). Methods: We performed a multivariate logistic regression and propensity score matched analyses in 13,115 patients (75% men) who underwent CABG between January 1, 1995 and December 31, 2009. The primary outcome was in-hospital mortality. Secondary outcomes included post-operative respiratory failure, stroke, myocardial infarction, sternal and leg wound infections, atrial fibrillation (AF), renal failure, need for postoperative intra-aortic balloon pump (IABP) support, and length of hospital stay. Results: A higher proportion of women (184; 5.6%) suffered in-hospital death compared to men (264; 2.7%), p < 0.0001. After propensity score matching (n = 3600 total, 1800 in each group), female gender was an independent predictor of mortality after isolated CABG (odds ratio [OR] = 1.84; 95% confidence interval [CI] 1.22-2.78). Women also experienced a higher incidence of postoperative complications including stroke (3.8% vs. 2.3%, OR 1.37; 95% CI 1.08-1.73) and leg wound infection (3.4% vs. 1.7%, OR 1.75; 95% CI 1.36-2.54) on multivariate regression analyses. However, these differences were not significant after propensity score matching. We also observed a lower risk of post-operative AF (21.2% vs. 22.1%, OR 0.78; 95% CI 0.70-0.86) in women that remained significant after propensity matching (O.R. 0.76; 95% C.I. 0.65-0.90). Length of hospital stay was longer in women compared with men (11.9 ± 9.0 vs. 10.4 ± 9.2 days, p < 0.0001). Conclusions: Female gender is an independent predictor of increased mortality and a lower incidence of post-operative AF after isolated CABG.
KW - Coronary artery bypass graft
KW - Gender
KW - Mortality
UR - https://www.scopus.com/pages/publications/84878573887
UR - https://www.scopus.com/pages/publications/84878573887#tab=citedBy
U2 - 10.1016/j.ijcard.2011.12.047
DO - 10.1016/j.ijcard.2011.12.047
M3 - Article
C2 - 22240765
AN - SCOPUS:84878573887
SN - 0167-5273
VL - 167
SP - 180
EP - 184
JO - International Journal of Cardiology
JF - International Journal of Cardiology
IS - 1
ER -