Gender and Age Influence In-hospital Mortality After CABG
Young women are at a significantly higher risk of in-hospital death after coronary artery bypass graft (CABG) surgery than men, Emory University researchers report in a rapid access release from the March 12th issue of Circulation: Journal of the American Heart Association.
“I was not surprised to find differences in mortality rates between men and women after CABG, but I was surprised to find such a huge difference,” lead author, Dr. Viola Vaccarino told Reuters Health.
Using the National Cardiovascular Network database, Dr. Vaccarino and colleagues, from Atlanta, collected data on 51,187 patients who underwent CABG between October 1993 and December 1999.
Although more women in the cohort had risk factors and comorbidities than men, women had higher left ventricular ejection fraction and fewer diseased vessels than men, the investigators note.
Analysis revealed that women under 50 years of age were three times more likely to die after CABG compared with men in the same age group (3.4% versus 1.1%). Women 50 to 59 years of age were 2.4 times more likely to die compared with same-aged men (2.6% versus 1.1%), the researchers found.
In older patients the gender difference was not as great, Dr. Vaccarino’s team reports. For women 80 years of age and older the risk of death after CABG was 9.0%, while for men in the same age group it was 8.3%.
The researchers are not sure, from these data, why there is this gender difference in mortality, Dr. Vaccarino said, but she speculated that surgical factors could contribute. CABG surgery is more difficult in women, due to the smaller size of the coronary arteries, she said. “We should look at the CABG procedure and see where it could be improved for women,” Dr. Vaccarino stressed.
“We need to understand what makes these younger women at higher risk compared with men. Perhaps these younger women have some as yet unidentified risk factors that put them at an increased risk of death,” Dr. Vaccarino added.
