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非体外循环冠状动脉搭桥术患者中,女性长期死亡风险较低。

Females are Associated with Lower Risks of Long-Term Mortality in Patients Undergoing Off-Pump Coronary Artery Bypass Grafting.

作者信息

Bai Chen, Wang Jiangang, Ye Qing, Zhao Cheng

机构信息

Department of Cardiovascular Surgery, Beijing Anzhen Hospital, Capital Medical University, Beijing - China.

出版信息

Arq Bras Cardiol. 2024 Nov;121(12):e20240221. doi: 10.36660/abc.20240221.

Abstract

BACKGROUND

In patients who underwent off-pump coronary artery bypass grafting (OPCABG), females were reported to have lower rates of in-hospital mortality rate and postoperative atrial fibrillation than males. However, the association between gender and long-term prognosis following OPCABG is rarely reported.

OBJECTIVE

This study aims to determine if women benefit more from OPCABG than men by comparing the difference in the risk of long-term all-cause mortality in patients with coronary chronic total occlusion (CTO).

METHODS

This is an observational, retrospective cohort study conducted in adult patients (≥18 years) with coronary CTO undergoing OPCABG at our hospital from January 2011 to December 2014. A multivariate Cox proportional hazards model was employed to assess the association of gender with the risk of all-cause mortality. A p-value of <0.05 was considered statistically significant.

RESULTS

Totally 1,256 participants were enrolled, among which 321 (25.6%) were females and 935 (74.4%) were males. During a maximum follow-up of 10 years, the all-cause mortality rate in women was significantly lower than that in men (10.3% vs. 24.3%, p<0.01). Multivariate Cox regression analysis indicated that women were significantly associated with a lower risk of all-cause mortality (HR=0.30, 95% CI: 0.20-0.44; p<0.01) after controlling for potential confounding factors.

CONCLUSION

Women benefit more from OPCABG surgery than men, as they have a lower risk of long-term all-cause mortality in patients with coronary CTO.

摘要

背景

据报道,在接受非体外循环冠状动脉旁路移植术(OPCABG)的患者中,女性的院内死亡率和术后房颤发生率低于男性。然而,关于OPCABG术后性别与长期预后之间的关联鲜有报道。

目的

本研究旨在通过比较冠状动脉慢性完全闭塞(CTO)患者长期全因死亡风险的差异,确定女性是否比男性从OPCABG中获益更多。

方法

这是一项观察性、回顾性队列研究,纳入了2011年1月至2014年12月在我院接受OPCABG的成年(≥18岁)冠状动脉CTO患者。采用多变量Cox比例风险模型评估性别与全因死亡风险的关联。p值<0.05被认为具有统计学意义。

结果

共纳入1256名参与者,其中女性321名(25.6%),男性935名(74.4%)。在最长10年的随访期间,女性的全因死亡率显著低于男性(10.3%对24.3%,p<0.01)。多变量Cox回归分析表明,在控制潜在混杂因素后,女性与较低的全因死亡风险显著相关(HR=0.30,95%CI:0.20-0.44;p<0.01)。

结论

在冠状动脉CTO患者中,女性从OPCABG手术中获益比男性更多,因为她们的长期全因死亡风险较低。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cbb5/11634319/edebbe4f27d6/0066-782X-abc-121-12-e20240221-gf01.jpg

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