Katircibaşi M Tuna, Koçum H Tolga, Baltali Mehmet, Erol Tansel, Tekin Abdullah, Yiğit Fatma, Tekin Göknur, Kiziltan H Tarik, Müderrisoğlu Haldun
Department of Cardiology, School of Medicine, Başkent University, Ankara, Adana, Turkey.
Anadolu Kardiyol Derg. 2007 Jun;7(2):134-9.
Early mortality after coronary artery bypass grafting is generally higher in women than in men. This study analyzes the effect of female gender on early mortality of coronary artery bypass grafting particularly for left main coronary artery disease.
Study population consisted of 144 consecutive patients (33 women, 111 men) undergoing coronary artery bypass grafting for left main coronary artery disease. Mean follow-up was 25.1 +/- 14.0 months. Data were collected retrospectively and presented as mean +/- standard deviation. Survival analysis was done using Kaplan-Meier actuarial curve method with the log rank univariate test, followed by Cox's proportional rate multivariate model.
Overall mortality was 7% in the patient population. Cox regression analysis revealed that the independent predictors of increased total mortality were female gender (HR 8.34, 95% CI 1.79 - 38.76, p=0.007), advanced age (HR 1.12, 95% CI 1.02-1.23, p=0.014), degree of left main coronary artery stenosis (HR 1.068, 95%CI 1.005-1.135, p=0.03), and left ventricular ejection fraction (HR 0.93, 95% CI 0.87-0.99, p=0.03). Female gender was found to be the only independent predictor of increased early mortality (HR 13.18, 95%CI 1.444-120.343, p=0.02). After discharge from the hospital, female gender was no more a predictor of increased mortality.
According to these data, we may assume that female gender is related with increased mortality in coronary artery surgery for left main disease in the pre-discharge period however after discharge from hospital, long-term benefit of female survivors of coronary artery bypass grafting operated on for left main coronary artery disease might be as good as in men.
冠状动脉搭桥术后女性的早期死亡率通常高于男性。本研究分析了女性性别对冠状动脉搭桥术早期死亡率的影响，特别是针对左主干冠状动脉疾病。
研究人群包括144例连续接受左主干冠状动脉疾病冠状动脉搭桥术的患者（33例女性，111例男性）。平均随访时间为25.1±14.0个月。数据进行回顾性收集，并以平均值±标准差表示。采用Kaplan-Meier精算曲线法和对数秩单因素检验进行生存分析，随后采用Cox比例风险多变量模型。
患者总体死亡率为7%。Cox回归分析显示，总死亡率增加的独立预测因素为女性性别（风险比8.34，95%可信区间1.79 - 38.76，p = 0.007）、高龄（风险比1.12，95%可信区间1.02 - 1.23，p = 0.014）、左主干冠状动脉狭窄程度（风险比1.068，95%可信区间1.005 - 1.135，p = 0.03）以及左心室射血分数（风险比0.93，95%可信区间0.87 - 0.99，p = 0.03）。女性性别被发现是早期死亡率增加的唯一独立预测因素（风险比13.18，95%可信区间1.444 - 120.343，p = 0.02）。出院后，女性性别不再是死亡率增加的预测因素。
根据这些数据，我们可以假设，女性性别与左主干疾病冠状动脉手术出院前死亡率增加有关，然而出院后，接受左主干冠状动脉疾病冠状动脉搭桥术的女性幸存者的长期获益可能与男性一样好。
