Gender differences in recovery after coronary artery bypass surgery

Vaccarino, Viola; Lin, Zhen; Kasl, Stanislav V.; Mattera, Jennifer A.; Roumanis, Sarah A.; Abramson, Jerome L.; Krumholz, Harlan M.

doi:10.1016/s0735-1097(02)02698-0

Cited by 194 publications

(119 citation statements)

References 26 publications

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“…Despite the scarce literature reviewing this issue in combined CABG and AVR surgery, much more has been accomplished with regard to isolated CABG outcomes throughout the past 2 decades. Numerous studies have consistently demonstrated increased post-operative morbidity and mortality amongst female patients in comparison to their male counterparts after CABG [1,6,12]. The review by Edwards et al [13] of 344,913 patients from the Society of Thoracic Surgeons National Cardiac Surgery Database further verified this hypothesis.…”

Section: Discussionmentioning

confidence: 94%

Does Patient Gender Affect Outcomes after Concomitant Coronary Artery Bypass Graft and Aortic Valve Replacement? An Australian Society of Cardiac and Thoracic Surgeons Database Study

Saxena¹,

Poh

Dinh

et al. 2011

Cardiology

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Objectives: Women undergoing isolated coronary artery bypass graft (CABG) surgery have been previously shown to be at an independently increased risk for post-operative morbidity and mortality. However, there are considerably less data on whether this trend remains true in patients undergoing concomitant aortic valve replacement (AVR) and CABG surgery. The aim of our study was to investigate this pertinent issue. Methods: Data obtained between June 2001 and December 2009 by the Australasian Society of Cardiac and Thoracic Surgeons Cardiac Surgery Database Program were retrospectively analysed. Demographic, operative data and post-operative complications were compared between male and female patients using χ² and t tests. Long-term survival analysis was performed using Kaplan-Meier survival curves and the log-rank test. Independent risk factors for short- and long-term mortality were identified using binary logistic and Cox regression, respectively. Results: Concomitant AVR and CABG surgery was undertaken in 2,563 patients; 31.8% were female. Female patients were older (mean age 76 vs. 73 years; p < 0.001) and presented more often with hypertension (p < 0.001) but less often with severely impaired ejection fraction (p < 0.001), peripheral vascular disease (p < 0.001) and triple vessel disease (p < 0.001). Women did not demonstrate an increased risk of 30-day mortality (4.8 vs. 3.3%) on univariate (p = 0.069) or multivariate (p = 0.236) analysis. Female gender was independently associated with post-operative myocardial infarction (p = 0.022) and red blood cell transfusion (p < 0.001). There was no difference in long-term survival between men and women on multivariate analysis (p = 0.413). Conclusion: Female gender is not associated with poorer short- or long-term outcomes after concomitant CABG and AVR surgery.

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Section: Discussionmentioning

confidence: 94%

Does Patient Gender Affect Outcomes after Concomitant Coronary Artery Bypass Graft and Aortic Valve Replacement? An Australian Society of Cardiac and Thoracic Surgeons Database Study

Saxena¹,

Poh

Dinh

et al. 2011

Cardiology

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“…As depression is generally found to be more common in women than in men [13] and psychosocial adjustment after an MI may be more difficult for women than for men [14], studies of these two factors in women are particularly warranted. From the Stockholm Female Coronary Risk Study, we reported that social isolation was an independent risk factor for the severity and extent of coronary atherosclerosis [15], and that the presence of two or more depressive symptoms was an independent predictor of recurrent cardiac events, whereas socially integrated women without depressive symptoms had the best prognosis [16].…”

Section: Introductionmentioning

confidence: 99%

Depressive Symptoms, Social Isolation, and Progression of Coronary Artery Atherosclerosis: The Stockholm Female Coronary Angiography Study

Wang

Mittleman

Leineweber

et al. 2006

Psychother Psychosom

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Background: Although both depressive symptoms and social isolation in relation to coronary heart disease have been studied previously, few have examined their joint effects on coronary atherosclerosis progression in women. Method: Among the women enrolled in the Stockholm Female Coronary Angiography Study, Sweden, between 1991 and 1994, 102 were evaluated for coronary atherosclerosis progression using a computer-assisted standardized assessment, repeated quantitative coronary angiographic documentation, of the mean luminal diameter change over 3 years in 10 predefined coronary segments. Depressive symptoms and social isolation were assessed by standard questionnaires. Results: Multivariable controlled mixed model ANOVAs revealed that women who were both depressed and socially isolated had the greatest disease progression: their absolute mean luminal diameter decreased by 0.18 mm [95% confidence interval (CI) = 0.11–0.24] and their percent narrowing was 5.5% (95% CI = 3.6–7.4), whereas in women who lacked both psychological risk factors, the mean luminal diameter decrease was 0.04 mm and their percent narrowing was 0.9%. These associations were independent of the baseline luminal diameter and standard risk factors, including age, smoking history, hypertension, and high-density lipoproteins. Conclusions:In women with coronary disease, depressive symptoms and social isolation in combination accelerated disease progression, suggesting a direct psychosocial effect on the atherosclerotic process. These findings provide an additional opportunity for therapeutic and preventive efforts against progression of coronary disease in women.

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“…More diffi cult recovery has been reported in women. 5 We found that female sex was not associated with increased mortality or short-term morbidity. This was in contrast to the fi ndings of Edwards and coworkers, who concluded that sex could be an independent risk factor for mortality.…”

Section: Discussionmentioning

confidence: 62%

Effects of sex, body mass index, and body size on the outcome of coronary artery bypass surgery: Iranian experience

Nemati

Astaneh

2010

Gen Thorac Cardiovasc Surg

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Gender differences in recovery after coronary artery bypass surgery

Abstract: After CABG surgery, women have a more difficult recovery compared with men, which is not explained by illness severity, presurgery health status, or other patient characteristics.

Cited by 194 publications

References 26 publications

Does Patient Gender Affect Outcomes after Concomitant Coronary Artery Bypass Graft and Aortic Valve Replacement? An Australian Society of Cardiac and Thoracic Surgeons Database Study

Does Patient Gender Affect Outcomes after Concomitant Coronary Artery Bypass Graft and Aortic Valve Replacement? An Australian Society of Cardiac and Thoracic Surgeons Database Study

Depressive Symptoms, Social Isolation, and Progression of Coronary Artery Atherosclerosis: The Stockholm Female Coronary Angiography Study

Effects of sex, body mass index, and body size on the outcome of coronary artery bypass surgery: Iranian experience

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