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Impact of off-pump techniques on sex differences in early and late outcomes after isolated coronary artery bypass grafts.
Ann Thorac Surg. 2009 Apr; 87(4):1090-6.AT

Abstract

BACKGROUND

Off-pump coronary artery bypass graft surgery (OPCAB) is associated with lower early mortality and benefits women disproportionately. The objective of this study was to assess the impact of off-pump techniques on sex differences in late outcomes.

METHODS

We reviewed a clinical database of consecutive patients who underwent isolated coronary artery bypass graft surgery (CABG) at FuWai Hospital from 1999 to 2005. Logistic regression analysis and proportional hazards modeling were used to investigate whether sex or surgery type were associated with early mortality and late outcomes (mortality, major cardiac and cerebral event).

RESULTS

Female sex was associated with higher rates of early death (adjusted odds ratio, 4.726; p < 0.0001), and OPCAB benefited women disproportionately for early mortality. Odds ratio of death for women versus men was 4.726 (p < 0.0001) in the conventional CABG on cardiopulmonary bypass group; odds ratio of death for women versus men was 1.344 (p = 0.5617) in the OPCAB group. Analysis of late outcomes indicated that OPCAB and cardiopulmonary bypass resulted in similar survival, regardless of sex. The women versus men hazard ratio of late mortality after CABG on cardiopulmonary bypass and OPCAB for women was 0.851 (p = 0.4984) and 0.650 (p = 0.2005), respectively. Women treated with OPCAB were less likely to be free from major cardiac and cerebral events than men treated with OPCAB. The women versus men hazard ratio of major cardiac and cerebral events after CABG on cardiopulmonary bypass and OPCAB for women was 1.079 (p = 0.4992) and 1.299 (p = 0.0387), respectively.

CONCLUSIONS

Compared with men, women are a high-risk group and benefit from off-pump operation in terms of early mortality after CABG. Conversely, during follow-up, women have high adjusted risks of major cardiac and cerebral events after OPCAB.

Authors+Show Affiliations

Chinese Academy of Medical Science, Peking Union Medical College, Fuwai Hospital & Cardiovascular Institute, Department of Surgery, Research Center for Cardiovascular Regenerative Medicine, Beijing, People's Republic of China.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

19324133

Citation

Fu, Shao-peng, et al. "Impact of Off-pump Techniques On Sex Differences in Early and Late Outcomes After Isolated Coronary Artery Bypass Grafts." The Annals of Thoracic Surgery, vol. 87, no. 4, 2009, pp. 1090-6.
Fu SP, Zheng Z, Yuan X, et al. Impact of off-pump techniques on sex differences in early and late outcomes after isolated coronary artery bypass grafts. Ann Thorac Surg. 2009;87(4):1090-6.
Fu, S. P., Zheng, Z., Yuan, X., Zhang, S. J., Gao, H. W., Li, Y., & Hu, S. S. (2009). Impact of off-pump techniques on sex differences in early and late outcomes after isolated coronary artery bypass grafts. The Annals of Thoracic Surgery, 87(4), 1090-6. https://doi.org/10.1016/j.athoracsur.2009.01.039
Fu SP, et al. Impact of Off-pump Techniques On Sex Differences in Early and Late Outcomes After Isolated Coronary Artery Bypass Grafts. Ann Thorac Surg. 2009;87(4):1090-6. PubMed PMID: 19324133.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Impact of off-pump techniques on sex differences in early and late outcomes after isolated coronary artery bypass grafts. AU - Fu,Shao-peng, AU - Zheng,Zhe, AU - Yuan,Xin, AU - Zhang,Shi-ju, AU - Gao,Hua-wei, AU - Li,Yan, AU - Hu,Sheng-shou, PY - 2008/08/26/received PY - 2009/01/15/revised PY - 2009/01/16/accepted PY - 2009/3/28/entrez PY - 2009/3/28/pubmed PY - 2009/4/14/medline SP - 1090 EP - 6 JF - The Annals of thoracic surgery JO - Ann Thorac Surg VL - 87 IS - 4 N2 - BACKGROUND: Off-pump coronary artery bypass graft surgery (OPCAB) is associated with lower early mortality and benefits women disproportionately. The objective of this study was to assess the impact of off-pump techniques on sex differences in late outcomes. METHODS: We reviewed a clinical database of consecutive patients who underwent isolated coronary artery bypass graft surgery (CABG) at FuWai Hospital from 1999 to 2005. Logistic regression analysis and proportional hazards modeling were used to investigate whether sex or surgery type were associated with early mortality and late outcomes (mortality, major cardiac and cerebral event). RESULTS: Female sex was associated with higher rates of early death (adjusted odds ratio, 4.726; p < 0.0001), and OPCAB benefited women disproportionately for early mortality. Odds ratio of death for women versus men was 4.726 (p < 0.0001) in the conventional CABG on cardiopulmonary bypass group; odds ratio of death for women versus men was 1.344 (p = 0.5617) in the OPCAB group. Analysis of late outcomes indicated that OPCAB and cardiopulmonary bypass resulted in similar survival, regardless of sex. The women versus men hazard ratio of late mortality after CABG on cardiopulmonary bypass and OPCAB for women was 0.851 (p = 0.4984) and 0.650 (p = 0.2005), respectively. Women treated with OPCAB were less likely to be free from major cardiac and cerebral events than men treated with OPCAB. The women versus men hazard ratio of major cardiac and cerebral events after CABG on cardiopulmonary bypass and OPCAB for women was 1.079 (p = 0.4992) and 1.299 (p = 0.0387), respectively. CONCLUSIONS: Compared with men, women are a high-risk group and benefit from off-pump operation in terms of early mortality after CABG. Conversely, during follow-up, women have high adjusted risks of major cardiac and cerebral events after OPCAB. SN - 1552-6259 UR - https://www.unboundmedicine.com/medline/citation/19324133/Impact_of_off_pump_techniques_on_sex_differences_in_early_and_late_outcomes_after_isolated_coronary_artery_bypass_grafts_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0003-4975(09)00136-2 DB - PRIME DP - Unbound Medicine ER -