Women have higher mortality following CABG compared to men

Researchers from the Department of Cardiothoracic Surgery, Weill Cornell Medicine, New York and the Department of Cardiac Surgery, Medical University of Vienna, in their cohort study of more than 1 million patients, reported this finding. They reported no significant improvement over the last decade.

Previous studies have reported that women undergoing CABG have higher mortality and morbidity than men. There is a lack of data mentioning if this difference has decreased over the last decade. The researchers evaluated the trend related to outcomes from 2011 to 2020 (US). Nearly 1 297 204 patients underwent surgery during this period.

The study summary includes the following points:

• Operative mortality was the primary outcome.
• The composite of operative mortality and morbidity were the secondary outcomes.
• The researchers calculated the association of the female sex with CABG.
• The mean age of patients was 66.0 years, including 24.5 % of women.
• The unadjusted operative mortality was higher in women at 2.8%.
• The women had a higher overall unadjusted incidence of the composite of operative mortality and morbidity than men, with 22.9%.
• The attributable risk for operative mortality varied for females from 1.28 in 2011 to 1.41 in 2020. The change was insignificant over the study period.
• The attributable risk was 1.08 in 2011 and 2020 for the composite of operative mortality and morbidity. The change was insignificant over the study period.

Concluding further, women have a greater risk of adverse outcomes after CABG and the researchers did not report any significant improvement over the last decade.

Further investigations are warranted regarding determinants of operative outcomes in women.

Further reading:

Gaudino M, Chadow D, Rahouma M, et al. Operative Outcomes of Women Undergoing Coronary Artery Bypass Surgery in the US, 2011 to 2020. JAMA Surg. Published online March 01, 2023. doi:10.1001/jamasurg.2022.8156