SPC365

Sex impact is not constant over time after coronary artery bypass grafting

Session: Posters (Sessão 2 - Écran 3) - Doença arterial coronária
Speaker: Inês Pereira de Sousa

Congress: CPC 2023
Topic: E. Coronary Artery Disease, Acute Coronary Syndromes, Acute Cardiac Care
Theme: 12. Coronary Artery Disease (Chronic)
Subtheme: 12.8 Coronary Artery Disease - Other
Session Type: Pósters Electrónicos
FP Number: ---
Authors: Inês Sousa; Sílvia Diaz; Rui J. Cerqueira; Ana Filipa Ferreira; Mário J. Amorim; Paulo Pinho; André P. Lourenço; António S. Barros; Francisca Saraiva; Adelino Leite-Moreira

<p style="text-align:justify"><span style="font-size:12pt"><span style="font-family:&quot;Times New Roman&quot;,serif"><strong><span style="font-family:&quot;Calibri Light&quot;,sans-serif"><span style="color:black">Introduction</span></span></strong><span style="font-family:&quot;Calibri Light&quot;,sans-serif"><span style="color:black">: Data about the impact of sex after coronary artery bypass grafting (CABG) have been conflicting and mainly focused on first 5-years of follow-up.</span></span></span></span></p>

<p style="text-align:justify"><span style="font-size:12pt"><span style="font-family:&quot;Times New Roman&quot;,serif"><strong><span style="font-family:&quot;Calibri Light&quot;,sans-serif"><span style="color:black">Aims: </span></span></strong><span style="font-family:&quot;Calibri Light&quot;,sans-serif"><span style="color:black">To compare long-term survival after CABG between women (W) and men (M).</span></span></span></span></p>

<p style="text-align:justify"><span style="font-size:12pt"><span style="font-family:&quot;Times New Roman&quot;,serif"><strong><span style="font-family:&quot;Calibri Light&quot;,sans-serif"><span style="color:black">Material and Methods: </span></span></strong><span style="font-family:&quot;Calibri Light&quot;,sans-serif"><span style="color:black">Longitudinal, retrospective, single-center study including consecutive patients who underwent primary is</span></span><span style="font-family:&quot;Calibri Light&quot;,sans-serif">olated CABG between 2004 and 2014. T<span style="color:black">his study obtained a random sample of 150 W and 150 M. The primary outcome was all-causes mortality, checked o</span>n December 2022. Time-to-event outcomes were studied using Kaplan-Meier Curves and Log-Rank test&nbsp;and multivariable Cox Regression. Median follow-up was 11 years and the maximum of 19 years.</span></span></span></p>

<p style="text-align:justify"><span style="font-size:12pt"><span style="font-family:&quot;Times New Roman&quot;,serif"><strong><span style="font-family:&quot;Calibri Light&quot;,sans-serif"><span style="color:black">Results:</span></span></strong><span style="font-family:&quot;Calibri Light&quot;,sans-serif"><span style="color:black"> From 3894 patients who underwent primary isolated CABG during the study period, 80% were men. The random sampling of 300 patients evidenced that W were older (median 68 vs 64 years, <em><span style="font-family:&quot;Calibri Light&quot;,sans-serif">p</span></em>&lt;0.01) and had higher incidence of cardiovascular risk factors, such as arterial hypertension (87% vs 70%, <em><span style="font-family:&quot;Calibri Light&quot;,sans-serif">p</span></em>&lt;0.01), diabetes (55% vs 39%, <em><span style="font-family:&quot;Calibri Light&quot;,sans-serif">p</span></em>&lt;0.01) and obesity (35% vs 20%, p&lt;0.01). They also had more frequently renal disease than M (70% vs 55%, <em><span style="font-family:&quot;Calibri Light&quot;,sans-serif">p</span></em>&lt;0.01), while M had more often peripheral arterial disease (23% vs 9%, <em><span style="font-family:&quot;Calibri Light&quot;,sans-serif">p</span></em>&lt;0.01) and active smoking habits (22% vs 4%, <em><span style="font-family:&quot;Calibri Light&quot;,sans-serif">p</span></em>&lt;0.01). Although the prevalence of 3-vessels disease was similar between W and M (71% vs 75%, p=0.48), the median number of grafts was higher in M vs. W (3 vs 2 <em><span style="font-family:&quot;Calibri Light&quot;,sans-serif">p</span></em>=0.01) and M had higher utilization of bilateral internal mammary artery (40% vs 21%, <em><span style="font-family:&quot;Calibri Light&quot;,sans-serif">p</span></em>&lt;0.01). At 5-, 10- and 15-years of follow-up, W vs M presented 88% vs 90%, 70% vs 70%, and 42% vs 56%, respectively (Log-Rank test, p=0.25). Kaplan-Meier curves evidenced that the hazard of sex is not proportional over time. The overall multivariable Cox regression model evidenced no differences for sex (HR: 0.97, 95%CI: 0.66-1.42, p=0.88). A split analysis at 10-years of follow-up showed that sex impacts only for patients who reached 10-years of follow-up, specifically that women have worse survival outcome (HR: 2.0, 95%CI: 1.02-4.10), while no effect of sex was evidenced within patients whose follow-up was less than 10-years (HR: 0.77, 95%: 0.49-1.20).</span></span></span></span></p>

<p style="text-align:justify"><span style="font-size:12pt"><span style="font-family:&quot;Times New Roman&quot;,serif"><strong><span style="font-family:&quot;Calibri Light&quot;,sans-serif"><span style="color:black">Conclusion:</span></span></strong><span style="font-family:&quot;Calibri Light&quot;,sans-serif"><span style="color:black"> Women have similar outcomes to men during early and mid-term follow-up, but worse survival results after 10-years of follow-up. Further studies are needed to establish the risk of W and improve their outcomes after CABG.</span></span></span></span></p>