Impact of gender and age on long-term outcomes of isolated coronary bypass surgery

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Abstract

Aim. Search for predictors of death and analysis of long-term survival after coronary bypass surgery.

Methods. The study included 1742 patients who underwent isolated coronary bypass surgery in Emergency Hospital (Naberezhnye Chelny) between 2011 and 2019, of whom 345 (19.8%) women and 1397 (80.2%) men. The women were older: their average age was 65.89±6.98 years — versus 61.29±7.71 years for men (p <0.001). The primary end point was death from any cause in the long-term postoperative period.

Results. The primary end point occurred in 170 patients (9.8% of the total sample), including 19 women and 151 men (11.2 vs. 88.8%). The average follow-up period was 43.65±27.55 months, the median follow-up period — 41 months. Both the 5-year survival rate (89% for women against 76% for men; p=0.042) and overall survival rate for the entire observation period were higher in women (86% versus 74%; p=0.042). Multivariate Cox regression analysis revealed that the long-term survival statistically significantly associated with age: up to 59 years [hazard ratio (HR) 0,43; confidence interval (CI) 0,28–0,65; р <0,001] and aged between 60 and 69 years (HR 0,62; CI 0,41–0,9; р <0,018), with gender: for female (HR 0,46; CI 0,29–0,77; р <0,002) and with factor of aortic occlusion during extracorporeal circulation (HR 2,42; CI 1,13-5,17; р <0,022) as well as the number of used internal thoracic arteries: one (HR 0,12; CI 0,02–0,65; р <0,015) or two (HR 0,08; CI 0,01–0,95; р <0,045).

Conclusion. Both 5-year and overall survival in women was higher; factors such as female gender and young age significantly influence survival in the long-term follow-up period after coronary bypass surgery, increasing it.

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About the authors

M A Poteev

Emergency Hospital

Author for correspondence.
Email: poteev-astra@mail.ru
Russian Federation, Naberezhnye Chelny, Russia

R A Yakubov

Emergency Hospital

Email: poteev-astra@mail.ru
Russian Federation, Naberezhnye Chelny, Russia

A G Khaisanov

Severnoe district hospital

Email: poteev-astra@mail.ru
Russian Federation, Severnoe, Russia

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Supplementary files

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1. JATS XML
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2. Рис. 1. График отдалённой выживаемости в зависимости от пола через 3, 5 и 7 лет наблюдения

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3. Рис. 2. Кривая кумулятивной выживаемости в зависимости от пола

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4. Рис. 3. График кумулятивной выживаемости при разных видах операций в общей совокупности больных; КШ — коронарное шунтирование; ИК — искусственное кровообращение; OPCAB — от англ. off-pump coronary artery bypass; MIDCAB — от англ. minimally invasive direct coronary artery bypass surgery

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© 2021 Poteev M.A., Yakubov R.A., Khaisanov A.G.

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