SPC365

Influence of Gender on Life Expectancy After Coronary Artery Bypass Surgery

Session: SESSÃO DE POSTERS 54 - INTERVENÇÃO MITRAL PERCUTÂNEA E CIRURGIA CARDÍACA
Speaker: Inês Sousa

Congress: CPC 2025
Topic: H. Interventional Cardiology and Cardiovascular Surgery
Theme: 26. Cardiovascular Surgery
Subtheme: 26.1 Cardiovascular Surgery – Coronary Arteries
Session Type: Cartazes
FP Number: ---
Authors: Inês Sousa; Sílvia Diaz; Rui Cerqueira; Ana Filipa Ferreira; Mario Jorge Amorim; Paulo Pinho; André Lourenço; António Barros; Adelino Leite-Moreira; Francisca Saraiva

<p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Aptos,sans-serif"><strong><span style="font-size:12.0pt"><span style="font-family:&quot;Times New Roman&quot;,serif"><span style="color:black">Introduction</span></span></span></strong><span style="font-size:12.0pt"><span style="font-family:&quot;Times New Roman&quot;,serif"><span style="color:black">: The need for coronary artery bypass grafting (CABG) surgery is steadily rising in the general population, driven by increasing life expectancy. Women, however, tend to have a poorer prognosis following CABG compared to men.</span></span></span></span></span></p>

<p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Aptos,sans-serif"><strong><span style="font-size:12.0pt"><span style="font-family:&quot;Times New Roman&quot;,serif"><span style="color:black">Aims</span></span></span></strong><span style="font-size:12.0pt"><span style="font-family:&quot;Times New Roman&quot;,serif"><span style="color:black">: To compare long-term survival in patients submitted to CABG with a sex and aged-matched general population.</span></span></span></span></span></p>

<p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Aptos,sans-serif"><strong><span style="font-size:12.0pt"><span style="font-family:&quot;Times New Roman&quot;,serif"><span style="color:black">Methods</span></span></span></strong><span style="font-size:12.0pt"><span style="font-family:&quot;Times New Roman&quot;,serif"><span style="color:black">: Longitudinal, retrospective, single center study, involving consecutive patients who underwent isolated primary CABG between 2004 and 2014. Exclusion criteria included emergency/salvage surgeries or the use of extracorporeal circulation without aortic clamping. All-cause mortality was assessed in February 2023. </span></span></span><span style="font-size:12.0pt"><span style="font-family:&quot;Times New Roman&quot;,serif">Long-term survival was evaluated through survival curve in the CABG cohort and general population. Portuguese life tables were taken from the INE (Instituto Nacional de Estat&iacute;stica), specifically for the study period plus follow-up (2004-2022), to estimate the expected number of deaths, using the age-specific death rate. To construct the survival curve for the reference population, estimate standardized mortality ratio (SMR = observed deaths/expected deaths) and to conduct the 1-sample Log-Rank test, comparing expected with observed deaths, we used the software provided by Massachusetts General Hospital Biostatistics Center.<span style="color:black"> The mean follow-up time was 11 years, with a maximum of 19 years.</span></span></span></span></span></p>

<p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Aptos,sans-serif"><strong><span style="font-size:12.0pt"><span style="font-family:&quot;Times New Roman&quot;,serif"><span style="color:black">Results</span></span></span></strong><span style="font-size:12.0pt"><span style="font-family:&quot;Gungsuh&quot;,serif"><span style="color:black">: From 3978 patients included , 21% were women (W). W were older (mean age 67&plusmn;9 vs. 63&plusmn;10 years, p&lt;0.001) and had a higher prevalence of cardiovascular risk factors and severe chronic kidney disease compared to men (M). M more frequently had peripheral arterial disease and smoking habits. Although three-vessel disease was similar between sexes (p=0.111), W were less frequently implanted with &ge;3 grafts (p&lt;0.001). At 5, 10, and 15 years of follow-up, the cumulative survival rates were 89%, 73%, and 57% for men, and 88%, 68%, and 46% for women, respectively. Comparing with the survival of the Portuguese population, CABG allowed M to equalize the risk of mortality to what was expected (SMR =1.1;95%CI:0.9-1.1), but W showed a higher risk of mortality after CABG than W in the reference population (SMR =1.6,95%CI:1.3-1.8).</span></span></span></span></span></p>

<p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Aptos,sans-serif"><strong><span style="font-size:12.0pt"><span style="font-family:&quot;Times New Roman&quot;,serif"><span style="color:black">Conclusion</span></span></span></strong><span style="font-size:12.0pt"><span style="font-family:&quot;Times New Roman&quot;,serif"><span style="color:black">: This single-center retrospective study demonstrated that CABG offers significant benefit for men, aligning their survival rates with those of the general aged-matched population. However, in women, post-CABG survival rates were lower than expected compared to the aged-matched population suggesting that CABG may be less effective for women. </span></span></span></span></span></p>