Impact of gender on 10-year outcome after coronary artery bypass grafting.

Abstract

OBJECTIVES\n\n\n\nMETHODS\nOur goal was to evaluate the impact of gender on the 10-year outcome of patients after isolated coronary artery bypass grafting (CABG) included in the Italian nationwide PRedictIng long-term Outcomes afteR Isolated coronary arTery bypass surgery (PRIORITY) study.\n\n\nRESULTS\nThe PRIORITY project was designed to evaluate the long-term outcomes of patients who underwent CABG and were included in 2 prospective multicentre cohort studies. The primary end point of this analysis was major adverse cardiac and cerebrovascular events. Baseline differences between the study groups were balanced with propensity score matching and inverse probability of treatment. Time to events was analysed using Cox regression and competing risk analysis.\n\n\nCONCLUSIONS\nThe study population comprised 10\u2009989 patients who underwent isolated CABG (women 19.6%). Propensity score matching produced 1898 well-balanced pairs. The hazard of major adverse cardiac and cerebrovascular event was higher in women compared to men [adjusted hazard ratio (HR) 1.13, 95% confidence interval (CI) 1.03-1.23; P\u2009=\u20090.009]. The incidence of major adverse cardiac and cerebrovascular event in women was significantly higher at 1\u2009year (HR 1.31, 95% CI 1.11-1.55; P\u2009<\u20090.001) and after 1\u2009year (HR 1.11, 95% CI 1.00-1.24; P\u2009=\u20090.05). Mortality at 10\u2009years in the matched groups was comparable (HR 1.04, 95% CI 0.93-1.16; P\u2009=\u20090.531). Women have significantly a higher 10-year risk of myocardial infarction (adjusted HR 1.40, 95% CI 1.17-1.68; P\u2009=\u20090.002) and percutaneous coronary intervention (adjusted HR 1.32, 95% CI 1.10-1.59; P\u2009=\u20090.003).