07/08. tbl. 104. árg. 2018

Outcome of coronary artery bypass grafting in women in Iceland

Árangur kransæðahjáveituaðgerða hjá konum á Íslandi

Introduction
The aim of this study was to evaluate the outcome of coronary artery bypass grafting (CABG) in women compared to men, with focus on short-term and long-term complications, 30 day mortality and survival.

 

Materials and methods
This was a retrospective study on all CABG patients operated in Iceland between 2001 and 2013. Clinical information was gathered from hospital charts and survival data was obtained from the National Statistics in Iceland. Overall survival was estimated with the Kaplan- Meier method. Logistic and Cox regression analysis were used to identify predictors of operative mortality and long-term survival. Mean follow-up was 6.8 years.

 

Results
Of 1755 patients 318 were women (18%). Women were on average four years older than men at the time of operation (69 vs. 65 yrs, p<0.001). Female patients had a higher incidence of hypertension (72 vs. 64%, p=0.009) and their EuroSCOREst was higher (6.1 vs. 4.3, p<0.001). The prevalence of diabetes, dyslipidemia and the extent of coronary artery disease was comparable between groups. The rate of short-term complications, both minor (53% vs. 48%, p=0.07) and major (27% vs. 32%, p=0.2), was similar and operative mortality for women was not statistically different from males (4% vs. 2%, p=0.08). Female gender was neither found to be a predictor of 30-day mortality (OR 0.99; 95%-CI: 0.98-1.01) nor survival (HR 1,08; 95%-ÖB: 0,82-1,42).

 

Conclusions
The number of women that undergo CABG is low and they are four years older than men when operated on. As is the case with men, outcome following CABG in Iceland is very good for women, their overall five-year survival being 87%.

 

Table I   Baseline characteristics of patients that underwent isolated CABG in Iceland 2001-2013, stratified by gender. Number (%) or means with standard deviation.

 

Table II   Surgical variables and length of hospital stay for patients that underwent isolated CABG in Iceland 2001-2013, stratified by gender.  Number (%) or means with standard deviation.

 

Table III   Short-term minor and major complications and 30 day mortality following CABG in Iceland 2001-2013, stratified by gender.

Table IVa Independent predictors of 30 day mortality following CABG in Iceland 2001-2013.

Table IVb   Independent predictors of death following CABG in Iceland 2001-2013.

Figure 1a   Overall survival after coronary artery bypass grafting in Iceland 2001-2013 with 95% confidence interval (broken lines).

Figure 1b   Freedom from MACCE after coronary artery bypass grafting in Iceland 2001-2013 with 95% confidence interval (broken lines).









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