Gender Differences in Survival after Coronary Artery Bypass Grafting—13-Year Results from KROK Registry

Author:

Hirnle Grzegorz1,Stankiewicz Adrian1,Mitrosz Maciej1ORCID,Aboul-Hassan Sleiman Sebastian2ORCID,Deja Marek3ORCID,Rogowski Jan4,Cichoń Romuald5,Anisimowicz Lech6,Bugajski Paweł7,Tobota Zdzisław8,Maruszewski Bohdan8,Hrapkowicz Tomasz9

Affiliation:

1. Department of Cardiac Surgery, Medical University of Bialystok, 15-276 Bialystok, Poland

2. Department of Cardiac Surgery and Interventional Cardiology, Faculty of Medicine and Medical Sciences, University of Zielona Gora, 65-417 Zielona Gora, Poland

3. Department of Cardiac Surgery, Upper-Silesian Medical Centre, Medical University of Silesia, 40-055 Katowice, Poland

4. Department of Cardiac and Vascular Surgery, Medical University of Gdansk, 80-211 Gdansk, Poland

5. Lower Silesian Center for Heart Diseases ‘Medinet’, Faculty of Medicine and Medical Sciences, University of Zielona Gora, 65-417 Zielona Gora, Poland

6. Department of Cardiac Surgery, Dr Antoni Jurasz Memorial University Hospital, 85-094 Bydgoszcz, Poland

7. Department of Cardiac Surgery, J. Struś Hospital, 61-285 Poznan, Poland

8. Department of Paediatric Cardiothoracic Surgery, Children’s Memorial Health Institute, 01-210 Warszawa, Poland

9. Department of Cardiac Surgery, Vascular Surgery and Transplantology, Silesian Centre for Heart Diseases, Medical University of Silesia, 41-800 Zabrze, Poland

Abstract

The influence of gender on both early and long-term outcomes of coronary artery bypass grafting (CABG) is not clearly defined. Objectives: This study aimed to assess the impact of gender on early and long-term mortality after CABG using data from the KROK Registry. Methods: All 133,973 adult patients who underwent CABG in Poland between 1 January 2009 and 31 December 2019 were included in the Polish National Registry of Cardiac Surgical Procedures (KROK Registry). The study enrolled 90,541 patients: 68,401 men (75.55%) and 22,140 women (24.45%) who met the inclusion criteria. Then, 30-day mortality, 1-year mortality, and long-term mortality rates were compared. Results: Advanced age, higher Canadian Cardiovascular Society (CCS) and New York Heart Association (NYHA) grade, diabetes, hypercholesterolemia, arterial hypertension, body mass index BMI > 35 kg/m2, and renal failure, before the propensity matching, were more frequently observed in women. Women more frequently underwent urgent surgery, including single and double graft surgery, and off-pump CABG (OPCAB) (p < 0.001). In propensity-matched groups, early mortality (30 days) was significantly higher in women (3.4% versus 2.8%, p < 0.001). The annual mortality remained higher in this group (6.6% versus 6.0%, p = 0.025). However, long-term mortality differed significantly between the groups and was higher in the male group (33.0% men versus 28.8% women, p < 0.001). Conclusions: There are no apparent differences in long-term mortality between the two sexes in the entire population. In propensity-matched patients, early mortality was lower for men, but the long-term survival was found to be better in women.

Publisher

MDPI AG

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