Long Term Health Outcomes Following Coronary Artery Bypass Grafting: A Different Journey for Men and Women

Abstract

Background:The applicability of the Short Form (SF36) questionnaire to disparate populations led us to use this tool to investigate how health-related quality-of-life (HRQoL) for patients who underwent coronary artery bypass grafting (CABG) is related to gender, age and survival.Method: SF36 data and the presence of cardiac symptoms were collected from 44 women and 166 men prior to surgery and from consenting survivors at one and eight-year follow-ups. Survival data were collected from government records for 18 years post operation. Paired t-tests, Pearson correlation coefficients, chi-squared tests and the log-rank test were used to investigate connections between HRQoL and age, presence of angina/breathlessness and survival within and across genders.Results: HRQoL improved significantly for males and females in almost all health domains at the one year follow-up. At the eight year follow-up most female domain scores showed further improvement whereas the majority of male domain scores declined. Cardiac symptoms were present in 75.8% of women and 68.3% of men (χ2=0.7120, p=0.3988) at the one-year follow-up, and 84.2% of women and 70.2% of men at the eight-year follow-up. Male long term survival (53.6% after 18 years) depended significantly on retaining post-operative improvements in HRQoL to the medium term (p<0.002 in 4 of 8 domains). Female long term survival (40.9%) was significantly less than male survival (p=0.0108) and depended on maintaining a steady upward trend in HRQoL over the medium term. Age was not a determinant in HRQoL following CABG. Long term male and female survival was not significantly different and approached those of age and gender matched samples from the general population. Conclusion:Strategies to improve HRQoL in women may support improved survival by reducing excess short term female mortality, but the effectiveness of the same strategy for men is less apparent.

Quantifying Relative Importance of Coronary Risk Factors on Patient Survival Following Coronary Artery Bypass Grafting: A Maximum Likelihood Analysis

“…In this study the rates of recurrence/relief of risks are estimated from data collected at the one and eight-year follow-ups. In this same cohort of patients earlier follow-up showed that well-being (SF36 scores) had also declined despite overall improvements in the initial years after operation 35 . This trend has been reported in other larger researches.…”