Sandner Sigrid, Kaider Alexandra, Riebandt Julia, Florian Alissa, Rizvanovic Selma, Bairey Merz C Noel, Lawton Jennifer S, Charlson Mary, Safford Monika M, Bergmair Thomas, Zuckermann Andreas, Gaudino Mario
Department of Cardiac Surgery Medical University Vienna Austria.
Department of Cardiothoracic Surgery, Weill Cornell Medicine New York Presbyterian Hospital New York NY USA.
J Am Heart Assoc. 2025 Apr;14(7):e039011. doi: 10.1161/JAHA.124.039011. Epub 2025 Mar 26.
Limited data exist on sex differences in guideline-recommended statin therapy for secondary prevention after coronary artery bypass surgery (CABG). We examined sex differences in statin use after CABG and the association between sex-specific statin use and mortality.
Data from the Austrian national cardiac surgery registry and federal social insurance claims database for patients who underwent CABG between 2013 and 2021 were used. Multivariable logistic regression models were calculated to obtain women-to-men odds ratios for filling any statin and high-intensity statin prescriptions. Cox proportional hazards models were used to evaluate the association between statin use and mortality. A total of 15 448 patients (19% women) were included. During the 5 years after CABG, statin use decreased from 95.7% to 85.9% in men and 95.2% to 84.3% in women (P for trend <0.0001; =0.48), high-intensity statin use decreased from 69.4% to 57.2% in men and 67.8% to 54.3% in women (P for trend <0.0001; =0.59). The adjusted odds ratio for filling any statin prescription comparing women with men was 1.03 (95% CI, 0.92-1.16) and for filling a high-intensity statin prescription was 1.12 (95% CI, 1.02-1.23). Statin use was associated with a significantly lower mortality risk in both sexes (any statin: hazard ratio [HR], 0.56 [95% CI, 0.46-0.68]; <0.0001, =0.22; high-intensity statin: HR, 0.52 [95% CI, 0.42-0.63]; <0.0001, =0.48).
Women were as likely as men to fill a statin prescription after CABG and more likely to fill a high-intensity prescription. Statin use was associated with a similar mortality risk reduction among women and men.
关于冠状动脉搭桥手术（CABG）后二级预防中指南推荐的他汀类药物治疗的性别差异，现有数据有限。我们研究了CABG后他汀类药物使用的性别差异以及特定性别的他汀类药物使用与死亡率之间的关联。
使用了来自奥地利国家心脏手术登记处和联邦社会保险索赔数据库中2013年至2021年期间接受CABG的患者的数据。计算多变量逻辑回归模型以获得女性与男性开具任何他汀类药物和高强度他汀类药物处方的比值比。使用Cox比例风险模型评估他汀类药物使用与死亡率之间的关联。总共纳入了15448名患者（19%为女性）。在CABG后的5年中，男性他汀类药物使用率从95.7%降至85.9%，女性从95.2%降至84.3%（趋势P<0.0001；P=0.48），高强度他汀类药物使用率男性从69.4%降至57.2%，女性从67.8%降至54.3%（趋势P<0.0001；P=0.59）。比较女性与男性开具任何他汀类药物处方的调整后比值比为1.03（95%CI，0.92-1.16），开具高强度他汀类药物处方的调整后比值比为1.12（95%CI，1.02-1.23）。他汀类药物的使用在两性中均与显著较低的死亡风险相关（任何他汀类药物：风险比[HR]，0.56[95%CI,0.46-0.68]；P<0.0001，P=0.22；高强度他汀类药物：HR，0.52[95%CI，0.42-0.63]；P<0.0001，P=0.48）。
CABG后女性开具他汀类药物处方的可能性与男性相同，开具高强度处方的可能性更大。他汀类药物的使用在女性和男性中与相似的死亡风险降低相关。
