Male–Female Differences Following Concomitant Coronary Artery Bypass Grafting and Aortic Valve Replacement Surgery
Authors' conclusion
The inherent risk profiles might be responsible for outcome differences in septuagenarians.
Study context
- Population
- Patients undergoing combined aortic valve replacement (AVR) and coronary artery bypass grafting (CABG) at one institution, January 2001–June 2021
- Participants
- 1,963 patients
- Exposure
- Female vs male patients undergoing combined CABG and AVR
- Outcome
- Mortality
- Follow-up
- 30 and 180 days
Methodological detailssingle-centre
- Single-centre
Main finding
As reported in the abstract
30-day mortality
P < 0.01
180-day mortality
P < 0.01
Observational data: associations, not effects.
Secondary outcomes
Mortality, septuagenarians (70-79 y, n = 1070) (subgroup) · 30 and 180 days
30-day mortality
P < 0.01
180-day mortality
P < 0.01
Predictors of 30-day mortality
| Comparison | OR (95% CI) | |
|---|---|---|
| Female sex | 3.33 (1.76–6.31) | |
| Higher age | 1.28 (1.13–1.45) | |
| DM | 1.93 (1.03–3.60) | |
| LVEF <30% | 3.26 (1.48–7.17) | |
| 0.10.31310Odds ratio (log scale) |
Predictors of 180-day mortality
| Comparison | OR (CI) | |
|---|---|---|
| Female sex | 1.93 (1.22–3.06) | |
| Higher age | 1.16 (1.06–1.26) | |
| DM | 1.70 (1.08–2.67) | |
| LVEF <30% | 2.23 (1.24–4.02) | |
| 0.20.5125Odds ratio (log scale) |
| Outcome | Estimate |
|---|---|
| Independent predictors of major adverse postoperative events (multivariable)Sex | 1.77 (CI 1.21–2.58) |
| Independent predictors of major adverse postoperative events (multivariable)LVEF <30% | 3.71 (CI 2.39–5.76) |
| IMA graft use and outcomesIMA graft use · 30-day mortality | 0.47 (CI 0.25–0.87) |
| IMA graft use and outcomesIMA graft use · 180-day mortality | 0.46 (CI 0.29–0.72) |
| IMA graft use and outcomesIMA graft use · adverse events | 0.61 (CI 0.42–0.88) |
- Internal mammary artery (IMA) graft use and outcomes: Infrequent use of IMA grafts associated with increased 30- and 180-day mortality and adverse events
Baseline differences in septuagenarians (Female vs Male)
- Females significantly older
- P < 0.01
- Females had better preserved LV function
- P = 0.01
- Females had higher incidence of DM
- P < 0.01
- Females received significantly fewer IMA conduits
- P < 0.01
Original publication
Male–Female Differences Following Concomitant Coronary Artery Bypass Grafting and Aortic Valve Replacement Surgery. ESC Heart Fail. Published 26 May 2024. doi:10.
Summarised from the published abstract; every number is checked against it