Bai Chen, Wang Jiangang, Ye Qing, Zhao Cheng
Department of Cardiovascular Surgery, Beijing Anzhen Hospital, Capital Medical University, Beijing - China.
Arq Bras Cardiol. 2024 Nov;121(12):e20240221. doi: 10.36660/abc.20240221.
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.
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).
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.
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.
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.
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。
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。
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。
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）。
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。
