Long-term outcomes of women compared to men after off-pump coronary artery bypass grafting—a propensity-matched analysis

Literature is not clear whether women experience increased mortality and adverse events after coronary artery bypass grafting (CABG). Studies have shown that women had comparative outcomes to men in off-pump CABG (OPCAB). Hence, we undertook this study to understand the short- and long-term outcomes of women compared to men after OPCAB.

Two thousand two hundred patients who underwent OPCAB from November 2014 to December 2021 were included in the study. Median follow-up period was 4.8 years. We performed propensity matching to match 404 women to 404 men.

In the unmatched cohort, women had increased cardiovascular mortality and inferior major adverse cardiovascular and cerebral event (MACCE)–free survival. In the matched cohorts, there was no difference in the 30-day mortality, long-term survival, MACCE-free survival, and cardiovascular mortality between the sexes. Cox proportional hazard showed post-operative renal failure (p-value < 0.001; hazard ratio (HR) 11.469) (confidence interval (CI) 2.911–45.180), post-operative stroke (p-value 0.023, HR 6.473) (CI 1.295–32.356), EuroSCORE II > 6 (p-value 0.022, HR 3.561) (1.204–10.531), emergency surgery (p-value 0.022, HR 3.498) (CI 1.202–10.177), and ventilation hours (p-value 0.004, HR 3.327) (CI 1.455–7.607) were the risk factors associated with long-term mortality in women.

Our study showed that the increased risk profile of women was the reason for inferior MACCE-free survival and increased cardiovascular mortality in women in the long term after OPCAB. When the risk factors were matched, women had comparable outcomes to men.