Key result
Among patients undergoing coronary artery bypass grafting, male gender was independently associated with a significantly higher prevalence of smoking (OR 3.96) and hyperuricemia compared to females.
Cohort (n=1,498)
No
Odds Ratio: 3.96 (95% CI 2.53–6.19)
Absolute Event Rate: 25% vs 7%
p-value: p=<0.001
In a Japanese registry of CABG patients, significant gender and age-related differences were observed in preoperative risk factors, highlighting the need for tailored risk management.
May inform gender-specific preoperative counseling in CABG; leaves open effects on outcomes and need for prospective validation.
BACKGROUND: It is unclear whether gender and aging influence the characteristics of patients who undergo coronary artery bypass grafting (CABG). METHODS: We retrospectively reviewed a clinical database of 1,498 patients (male/female = 1133/365, age 67 ± 9 years) who underwent CABG at Fukuoka University Hospital from 1994 to 2010. RESULTS: Male showed significantly younger, higher percentages (%) of smoking and hyperuricemia (HU), higher levels of serum creatinine, and lower % hypertension (HT) and diabetes mellitus (DM), and lower levels of left ventricular ejection fraction than female. In multivariate analysis, all parameters identified independent variables associated with the gender difference. Next, we divided the patients into 5 groups according to age, and each group was then separated by gender. The % of males significantly decreased with aging, whereas % female significantly increased. Although % smoking and estimated glomerular filtration rate (eGFR), and body mass index (BMI) in all patients, males and females significantly decreased with aging, HU, left ventricular end diastolic pressure and the number of significantly stenosed coronary vessels were not associated with gender or aging. Interestingly, % HT in all patients and males significantly increased with aging, whereas that in females was not associated with aging. Serum low-density lipoprotein cholesterol levels in males significantly decreased with aging, while those in all patients and females were not associated with aging. In this contemporary data set, the decreases in % smoking and eGFR with aging were common characteristics in male and female patients. In addition, there were gender and aging differences in % smoking, % HT, BMI and eGFR, whereas no differences were observed in % DM, % dyslipidemia or % HU. CONCLUSIONS: Before CABG, high-risk patients with coronary artery disease who is going to undergo CABG may need to be managed more strictly considering to gender and age to avoid CABG.
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Shimizu et al. (2012) conducted a cohort in Coronary artery disease requiring coronary artery bypass grafting (n=1,498). Male gender vs. Female gender was evaluated on Smoking prevalence as an independent variable associated with gender (OR 3.96, 95% CI 2.53-6.19, p=<0.001). Among patients undergoing coronary artery bypass grafting, male gender was independently associated with a significantly higher prevalence of smoking (OR 3.96) and hyperuricemia compared to females.
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