Sex-Specific Differences in Early Occlusion Rate After Coronary Artery Bypass Grafting.

Abstract

This study assessed whether there is a difference in early bypass graft occlusion rates after coronary artery bypass grafting (CABG) between men and women. Consecutive adult patients undergoing isolated CABG surgery were included. Bypass graft patency was assessed in a postoperative electrocardiogram-gated coronary bypass computed tomography heart scan before discharge. Follow-up data included mortality, major adverse cardiac and cerebrovascular events, rehospitalizations, and cardiac reinterventions. The study included 589 patients (mean, 67 years; SD, 9.4 years), of whom 95 (16%) were women. Bypass graft occlusion was detected in 45 of 589 patients (7.6%) and was seen significantly more often in female patients compared with male patients (n = 13 [14%] vs n = 32 [6.5%], P = .02). This resulted in 14 of 292 (4.8%) and 35 of 1690 (2.1%) occluded grafts (P < .01), respectively. Female sex was significantly associated with higher odds of graft occlusion (odds ratio, 2.6; 95% CI, 1.1-5.7; P = .02). During the median follow-up of 14.5 months (interquartile range, 13.3-16.5 months) in 292 patients, overall mortality was 3.1% (n = 9), with higher incidence of rehospitalizations (28% vs 4.1%, P = .01) and reinterventions (28% vs 2.6%, P < .01) observed in patients with occluded grafts. No statistically significant differences in follow-up outcomes were observed between male and female patients. Early bypass graft occlusion, detected through standardized postoperative computed tomography scans before discharge, occurred significantly more frequently in female patients compared with male patients after isolated CABG surgery.