Women Have Poorer Outcome After CABG

A long term study of patients who underwent coronary artery bypass graft (CABG) surgery shows that women have a poorer outcome after CABG than men.

Dr. Veena Guru, of the Institute for Clinical Evaluative Sciences (Toronto, Canada), presented data from a population-based cohort study of 68,774 patients, 15,043 of whom were women, who underwent CABG between September 1991 and April 2002. Follow-up was as long as 11 years. Survival rates and readmission for cardiac causes or stroke were assessed for the two genders. Women were older (average age 65, compared to 62 in men), more likely to present with urgent or emergent status (64% vs. 56%), and less likely to receive arterial grafts (70% vs. 78%).

Women had a 50% higher rate of cardiac readmission in the first year after surgery, and this increased risk persisted after one year. This was primarily due to readmissions for unstable angina and congestive heart failure. However, mortality rates and revascularization rates were approximately the same for both women and men. The results were published in the January 31, 2006, issue of Circulation, the journal of the American Heart Association (AHA).

"The higher rates of readmission and congestive heart failure after CABG may indicate delayed referral or suboptimal timing of CABG. In an era of angioplasty with drug-eluting stents, genetic typing and more in the way of approved medical care, we need to understand the best strategy for women with coronary artery disease, said Dr. Guru.



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Institute for Clinical Evaluative Sciences