THE IMPACT OF FEMALE GENDER ON EARLY AND LONG-TERM OUTCOMES AFTER CORONARY ARTERY BYPASS GRAFTING SURGERY

Aim: Data on female gender differences on clinical prognosis after coronary artery bypass grafting (CABG) are still controversial. We retrospectively evaluated the impact of women patients in comparison with men undergoing CABG on long-term outcome. Methods: Between December 2014 and March 2022, 1044 consecutive patients (162 females, 15.5%, 882 males, 84.5%) underwent isolated CABG. The mean follow-up was 40±27 (median 38) months. Logistic and Cox model analysis regressions were used to assess the risk of female gender and other variables, Kaplan-Meier estimates to assess survival rates. Results: Baseline characteristics were similar, Euroscore-2 was higher in women (3.23% vs 2.63%; P=0.04). There was no difference in the use of left internal mammary artery (95.5% vs 94.9%; P >0.80). Women did not have a significant higher operative mortality than men (n=5, 3.08% vs n=17, 1.93%; P =0.37). Independent predictors of early mortality were emergency CABG ( P <0.0001), PCI within 30 days ( P= 0.002), and the higher Euroscore-2 ( P =0.016). At 7.5 years, actuarial survival was 87%±3.6% for female gender vs 88%±1.9% for male gender, freedom from cardiac death 97%±1.8% vs 96.6%±1.0%, from MACE 87%±6.2% vs 90%±2.5% (P-values>0.5). Independent predictor of all-causes death and cardiac death was the advanced age (74 years in dead patients vs 64 years in survivors; P< 0.0001). Female gender was not a predictor of neither operative mortality ( P =0.34) nor worse long-term outcome ( P =0.41). Conclusions: Women undergoing CABG do not appear to be associated with worse early prognosis. Freedom from late all-causes mortality, cardiac death and cardiac events are equally satisfactory, highlighting the positive protective effect of CABG over time also in women.