Key result
Female patients with coronary chronic total occlusion undergoing OPCABG had a significantly lower risk of long-term all-cause mortality compared to males (HR 0.30; 95% CI 0.20-0.44; p<0.01).
Why the study?
The association between gender and long-term prognosis following off-pump coronary artery bypass grafting is rarely reported, prompting this evaluation in patients with coronary chronic total occlusion.
Does female sex reduce long-term all-cause mortality in adult patients with coronary CTO undergoing OPCABG?
Cohort (n=1,256)
No
Does female sex reduce long-term all-cause mortality in adult patients with coronary CTO undergoing OPCABG?
Hazard Ratio: 0.3 (95% CI 0.2–0.44)
Absolute Event Rate: 10.3% vs 24.3%
p-value: p=<0.01
In patients with coronary chronic total occlusion undergoing off-pump CABG, female sex is associated with a significantly lower risk of long-term all-cause mortality compared to male sex.
Women with CTO had lower post-OPCABG mortality; observational association leaves open causal inference and practice change.
Background In patients who underwent off-pump coronary artery bypass grafting (OPCABG), females were reported to have lower rates of in-hospital mortality rate and postoperative atrial fibrillation than males. However, the association between gender and long-term prognosis following OPCABG is rarely reported. Objective This study aims to determine if women benefit more from OPCABG than men by comparing the difference in the risk of long-term all-cause mortality in patients with coronary chronic total occlusion (CTO). Methods This is an observational, retrospective cohort study conducted in adult patients (≥18 years) with coronary CTO undergoing OPCABG at our hospital from January 2011 to December 2014. A multivariate Cox proportional hazards model was employed to assess the association of gender with the risk of all-cause mortality. A p-value of <0.05 was considered statistically significant. Results Totally 1,256 participants were enrolled, among which 321 (25.6%) were females and 935 (74.4%) were males. During a maximum follow-up of 10 years, the all-cause mortality rate in women was significantly lower than that in men (10.3% vs. 24.3%, p<0.01). Multivariate Cox regression analysis indicated that women were significantly associated with a lower risk of all-cause mortality (HR=0.30, 95% CI: 0.20-0.44; p<0.01) after controlling for potential confounding factors. Conclusion Women benefit more from OPCABG surgery than men, as they have a lower risk of long-term all-cause mortality in patients with coronary CTO.
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Bai et al. (2024) conducted a cohort in Coronary chronic total occlusion (CTO) (n=1,256). Female gender vs. Male gender was evaluated on All-cause mortality (HR 0.30, 95% CI 0.20-0.44, p=<0.01). Female patients with coronary chronic total occlusion undergoing OPCABG had a significantly lower risk of long-term all-cause mortality compared to males (HR 0.30; 95% CI 0.20-0.44; p<0.01).
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