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Comparison of 3-Year Outcomes for Coronary Artery Bypass Graft Surgery and Drug-Eluting Stents: Does Sex Matter?
Journal article   Peer reviewed

Comparison of 3-Year Outcomes for Coronary Artery Bypass Graft Surgery and Drug-Eluting Stents: Does Sex Matter?

Edward L Hannan, Ye Zhong, Chuntao Wu, Alice K Jacobs, Nicholas J Stamato, Samin Sharma, Jeffrey P Gold and Andrew S Wechsler
The Annals of thoracic surgery, v 100(6), pp 2227-2236
Dec 2015
DOI: https://doi.org/10.1016/j.athoracsur.2015.05.103
PMID: 26294345
Featured in Collection :   UN Sustainable Development Goals @ Drexel

Abstract

Aged Aged, 80 and over Confidence Intervals Coronary Artery Bypass - methods Coronary Artery Disease - mortality Coronary Artery Disease - surgery Drug-Eluting Stents Female Follow-Up Studies Hospital Mortality - trends Humans Incidence Male Middle Aged New York - epidemiology Postoperative Complications - epidemiology Proportional Hazards Models Registries Retrospective Studies Risk Factors Sex Distribution Sex Factors Survival Rate - trends Time Factors Treatment Outcome
Several randomized controlled trials and observational studies have compared outcomes for coronary artery bypass graft (CABG) surgery and drug-eluting stents (DES), but these studies have not thoroughly investigated the relative difference in outcomes by sex. We aimed to compare 3-year outcomes (mortality, mortality/myocardial infarction/stroke, and repeat revascularization) for CABG surgery and percutaneous coronary interventions with DES by sex. A total of 4,532 women (2,266 pairs of CABG and DES patients) and 11,768 men (5,884 pairs) were propensity matched separately using multiple patient risk factors and were compared with respect to 3-year outcomes. Both women and men receiving DES had significantly higher mortality rates (adjusted hazard ratio, 1.28; 95% confidence interval, 1.06 to 1.54 and adjusted hazard ratio, 1.22; 95% confidence interval, 1.06 to 1.41, respectively) and myocardial infarction/mortality/stroke rates (adjusted hazard ratio, 1.40; 95% confidence interval, 1.19 to 1.64 and adjusted hazard ratio, 1.36; 95% confidence interval, 1.20 to 1.54, respectively) with DES. The advantage for CABG surgery was also present for several preselected patient subgroups. Men had consistently lower adverse outcome rates than women for both procedures. For example, the mortality rates for CABG and DES for men were 8.0% and 9.1%, compared with respective rates of 11.8% and 13.7% for women. For women, the advantage of CABG surgery over DES is very similar to what was found for men, and this advantage persisted for patients with and without high-risk characteristics.

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16 citations in Web of Science
17 citations in Scopus

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UN Sustainable Development Goals (SDGs)

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#3 Good Health and Well-Being

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Collaboration types
Domestic collaboration
Web of Science research areas
Cardiac & Cardiovascular Systems
Respiratory System
Surgery
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