Osherov Azriel, Gallego-Colon Enrique, Abu-Alkean Ismael, Nemik Dimitri, Orlov Ian, Jafari Jamal
Department of Cardiology, Barzilai Medical Center, The Ben-Gurion University of the Negev, Hahistadrout 2, 7830604, Ashkelon, Israel.
J Cardiothorac Surg. 2024 Dec 5;19(1):643. doi: 10.1186/s13019-024-03139-2.
Saphenous vein graft percutaneous coronary intervention (SVG PCI) following coronary artery bypass grafting (CABG) is commonly used procedure for patients presenting with acute coronary syndrome (ACS). Emerging evidence suggests gender-based differences influencing SVG intervention clinical outcomes. This study aimed to analyze the impact of gender and various patient characteristics, procedural intricacies, anatomical considerations, and perioperative factors as potential risk determinants for SVG failure post-CABG surgery.
A retrospective, single-center, analysis was conducted on post-CABG patients at Barzilai Medical Center Ashkelon from 2010 to 2023 to assess gender-based differences in SVG PCI incidence.
Of the 72 ACS patients undergoing SVG PCI, a notably higher incidence was observed in men. However, graft failure occurred earlier in women compared to men (13.50 ± 6.59 SD years vs. 22.13 ± 5.66 SD years). Women exhibited a 1.2 times higher likelihood of earlier PCI than men (OR 1.24 CI 1.077 to 1.487, p = 0.0066) after adjusting for age, smoking, diabetes, hypertension, and hyperlipidemia.
Gender differences in the incidence of SVG PCI and graft failure denote the need for gender-tailored follow-up and early intervention to optimize graft patency and potentially enhance long-term clinical outcomes. Integrating gender-specific approaches into post-CABG management could significantly improve patient care and prognosis.
冠状动脉旁路移植术(CABG)后大隐静脉移植血管经皮冠状动脉介入治疗(SVG PCI)是急性冠状动脉综合征(ACS)患者常用的治疗方法。新出现的证据表明,性别差异会影响SVG介入治疗的临床结果。本研究旨在分析性别以及各种患者特征、手术复杂性、解剖学因素和围手术期因素作为CABG术后SVG失败潜在风险决定因素的影响。
对2010年至2023年在阿什凯隆的巴尔齐莱医疗中心接受CABG手术的患者进行回顾性单中心分析,以评估SVG PCI发生率的性别差异。
在72例接受SVG PCI的ACS患者中,男性的发生率明显更高。然而,与男性相比,女性的移植血管失败发生得更早(平均年龄13.50±6.59标准差岁 vs. 22.13±5.66标准差岁)。在调整年龄、吸烟、糖尿病、高血压和高脂血症后,女性早期PCI的可能性比男性高1.2倍(OR 1.24,CI 1.077至1.487,p = 0.0066)。
SVG PCI发生率和移植血管失败的性别差异表明,需要进行针对性别的随访和早期干预,以优化移植血管通畅性并可能改善长期临床结果。将针对性别的方法纳入CABG术后管理可显著改善患者护理和预后。