Comparison of Early and Late Mortality in Men and Women After Isolated Coronary Artery Bypass Graft Surgery in Stockholm, Sweden, 1980 to 1989

Hammar, Niklas; Sandberg, Eva; Larsen, Flemming; Ivert, Torbjörn

doi:10.1016/s0735-1097(96)00531-1

Cited by 76 publications

(59 citation statements)

References 15 publications

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“…Although long-term outcomes with CABG in women are similar to or even better than those in men, women have higher rates of periprocedural morbidity and mortality. [1133][1134][1135][1136][1137][1138][1139] Several hypotheses have been suggested to explain this increased morbidity and mortality, including older age at presentation, more frequent need for urgent revascularization, more comorbid conditions, smaller body surface area and coronary arterial dimensions, and increased risk of bleeding. The fact that women on average are older than men at the time of CABG is thought, at least in part, to be due to the loss of the protective effects of estrogen with menopause.…”

Section: Womenmentioning

confidence: 99%

2011 ACCF/AHA Guideline for Coronary Artery Bypass Graft Surgery

et al. 2011

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Section: Womenmentioning

confidence: 99%

2011 ACCF/AHA Guideline for Coronary Artery Bypass Graft Surgery

et al. 2011

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“…[419][420][421][422][423] However, the weight of evidence indicates that short-term mortality is higher in women. The most recent data from the STS National Cardiac Surgery Database for 2002 indicate an operative mortality of 3.54% in women compared with 2.15% in men.…”

Section: -415mentioning

confidence: 99%

“…379,422,[428][429][430][431] In some studies, women had even better long-term survival than men after adjusting for risk factors. 379,420 The reasons for improved longterm, but not short-term, survival are speculative.…”

Section: Long-term Mortalitymentioning

confidence: 99%

A comprehensive view of sex-specific issues related to cardiovascular disease

Pilote¹,

Dasgupta²,

Guru³

et al. 2007

Canadian Medical Association Journal

375

256

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A comprehensive view of sex-specific issues related to cardiovascular disease Cardiovascular disease (CVD) is the leading cause of mortality in women. In fact, CVD is responsible for a third of all deaths of women worldwide and half of all deaths of women over 50 years of age in developing countries. The prevalence of CVD risk factor precursors is increasing in children. Retrospective analyses suggest that there are some clinically relevant differences between women and men in terms of prevalence, presentation, management and outcomes of the disease, but little is known about why CVD affects women and men differently. For instance, women with diabetes have a significantly higher CVD mortality rate than men with diabetes. Similarly, women with atrial fibrillation are at greater risk of stroke than men with atrial fibrillation. Historically, women have been underrepresented in clinical trials. The lack of good trial evidence concerning sex-specific outcomes has led to assumptions about CVD treatment in women, which in turn may have resulted in inadequate diagnoses and suboptimal management, greatly affecting outcomes. This knowledge gap may also explain why cardiovascular health in women is not improving as fast as that of men. Over the last decades, mortality rates in men have steadily declined, while those in women remained stable. It is also becoming increasingly evident that gender differences in cultural, behavioural, psychosocial and socioeconomic status are responsible, to various degrees, for the observed differences between women and men. However, the interaction between sex-and gender-related factors and CVD outcomes in women remains largely unknown. CMAJ 2007;176(6):S1-44 Although cardiovascular disease (CVD) is common, significant sex-related differences in its epidemiology have only recently been appreciated. The objective of this section is to demonstrate that there are sex-specific differences in the prevalence, complications and burden of CVD in terms of mortality, hospital admissions and quality of life. Abstract Search strategyA MEDLINE search was conducted using the MeSH terms "cardiovascular disease" OR "atrial fibrillation" OR "congestive heart failure." A second search used the terms "prevalence" OR "incidence" OR "mortality" and the final search combined the results of the first 2 searches and added the terms "gender" OR "sex." Articles identified in this manner were retrieved and their reference lists searched for additional relevant articles. The search was limited to English-language publications, but no other restrictions were applied. Other data sources included Web sites of the World Health Organization, the Canadian Institute for Health Information and the National Centre for Health Statistics. Thirty-three original studies were reviewed. Studies were included if they were cohort studies, case-control studies or nested cohort studies that examined the incidence, prevalence or mortality of CVD, congestive heart failure or atrial fibrillation. The studies had to include data on both ...

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“…16 It has been suggested that complete revascularization, use of arterial grafts and the off-pump technique might decrease the disparity in mortality between female and male patients. [16][17][18] However, evidence still indicates that short-term mortality is higher in females than in males. 19 There have been no reports with regard to gender differences in clinical and angiographic outcomes after CABG from Japanese institutes.…”

mentioning

confidence: 99%

Gender Differences in Clinical and Angiographic Outcomes After Coronary Artery Bypass Surgery

Fukui

Takanashi

2010

Circ J

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Background:The impact of gender on outcome after coronary artery bypass grafting (CABG) is controversial. The aim of this study was to compare the differences of clinical and angiographic outcomes between female and male patients after CABG. Methods and Results:The records of 954 patients who underwent isolated CABG between 2004 and 2009 were reviewed. There were 188 female and 766 male patients. Female patients were smaller (P<0.0001) and had a more unstable status (P=0.0024) preoperatively compared with the male patients. Left internal thoracic artery (ITA) use was identical in both genders. However, the right ITA (P=0.006) and radial artery (P<0.0001) use were less frequent in females compared with that in males. Consequently, the use of saphenous vein grafts (SVGs) was more frequent in females than in males (P<0.0001). Mortality was similar between the genders (1.0% vs 1.1%). Although the rate of major complications was not significantly different between the genders (12.2% vs 9.5%), the cerebrovascular event rate was higher in females compared with that in males (4.3% vs 1.6%; P= 0.0432). Patency rates of arterial grafts were not significantly different between the genders; however, those of SVGs were lower in females than those in males (88.6% vs 96.1%; P=0.0003). Conclusions:The clinical outcomes of females after CABG were comparable with those of males. (Circ J 2010; 74: 2103 - 2108

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Comparison of Early and Late Mortality in Men and Women After Isolated Coronary Artery Bypass Graft Surgery in Stockholm, Sweden, 1980 to 1989

Abstract: The results suggest that men and women run similar risks of early and late mortality after CABG when patient characteristics are taken into account.

Cited by 76 publications

References 15 publications

2011 ACCF/AHA Guideline for Coronary Artery Bypass Graft Surgery

2011 ACCF/AHA Guideline for Coronary Artery Bypass Graft Surgery

A comprehensive view of sex-specific issues related to cardiovascular disease

Gender Differences in Clinical and Angiographic Outcomes After Coronary Artery Bypass Surgery

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