Sex Difference in Coronary Artery Bypass Grafting: Preoperative Profile and Early Outcome.

OBJECTIVE: According to the available risk-stratification systems, women have a higher risk of mortality than men after coronary artery bypass grafting (CABG). In this study, the authors investigated the authors' CABG database to trace factors contributing to this difference in outcome between sexes. DESIGN: A retrospective patient record study. SETTING: This single-center study was performed at the Catharina Hospital in Eindhoven, the Netherlands. PARTICIPANTS: The study comprised 17,919 patients, of whom 4,016 (22.4%) were women and 13,903 (77.6%) were men. INTERVENTIONS: Coronary artery bypass grafting was performed between January 1998 and July 2016. MEASUREMENTS AND MAIN RESULTS: Early mortality was significantly higher in women than in men (2.7% v 1.9%; p = 0.001). Regarding the baseline characteristics, women were older and had a lower hemoglobin level and a lower creatinine level than men. Women more often had hypertension, diabetes, underweight (body mass index [BMI] <20 kg/m2), and obesity (BMI >30 kg/m2). The mean number of grafts per patient was less in women than in men (3.2 ± 1.1 v 3.5 ± 1.1; p < 0.001). However, the mean cross-clamp time per graft was longer in female patients than in male patients (11.6 ± 8.7 min. v 11.2 ± 7.0 min.; p = 0.013). Logistic regression analyses showed that chronic obstructive pulmonary disease, peripheral vascular disease, cross-clamp time, and underweight were independent risk factors for early mortality only in men. CONCLUSION: The preoperative patient profile is significantly different between men and women undergoing CABG. The predictive value of well-known risk factors for early mortality is different between the 2 sexes.