Effect of female gender on the outcome of coronary artery bypass surgery for left main coronary artery diseas

Katırcıbaşı, M. Tuna; Koçum, H.Tolga; Baltalı, Mehmet; Erol, Tansel; Tekin, Abdullah; Yiğit, Fatma; Tekin, Göknur; Tarık Kızıltan, H.; Müderrisoğlu, Haldun

Original Investigation

M. Tuna Katırcıbaşı ¹ , H.Tolga Koçum ² , Mehmet Baltalı ² , Tansel Erol ³ , Abdullah Tekin ² , Fatma Yiğit ² , Göknur Tekin ¹ , H. Tarık Kızıltan ⁴ , Haldun Müderrisoğlu ⁵

¹Department of Cardiology, School of Medicine, Ba?kent University, Ankara, Adana, Turkey
²Department of Cardiology Surgery, School of Medicine, Başkent University, Ankara, Adana, Turkey
³Department of 2Cardiology, Faculty of Medicine, Başkent University, Ankara, Turkey
⁴Department of Cardiovascular Surgery, School of Medicine, Ba?kent University, Ankara, Adana, Turkey
⁵Department of Cardiology, Faculty of Medicine, Başkent University, Ankara, Turkey

Anatol J Cardiol 2007; 7(2): 134-139 PubMed ID: 17513207

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Abstract

Objective: Early mortality after coronary artery bypass grafting is generally higher in women than in men. This study analyzes the effect of female gender on early mortality of coronary artery bypass grafting particularly for left main coronary artery disease. Methods: Study population consisted of 144 consecutive patients (33 women, 111 men) undergoing coronary artery bypass grafting for left main coronary artery disease. Mean follow-up was 25.1 ± 14.0 months. Data were collected retrospectively and presented as mean ± standard deviation. Survival analysis was done using Kaplan-Meier actuarial curve method with the log rank univariate test, followed by Cox's proportional rate multivariate model. Results: Overall mortality was 7% in the patient population. Cox regression analysis revealed that the independent predictors of increased total mortality were female gender (HR 8.34, 95% CI 1.79 - 38.76, p=0.007), advanced age (HR 1.12, 95% CI 1.02-1.23, p=0.014), degree of left main coronary artery stenosis (HR 1.068, 95%CI 1.005-1.135, p=0.03), and left ventricular ejection fraction (HR 0.93, 95% CI 0.87-0.99, p=0.03). Female gender was found to be the only independent predictor of increased early mortality (HR 13.18, 95%CI 1.444-120.343, p=0.02). After discharge from the hospital, female gender was no more a predictor of increased mortality. Conclusion: According to these data, we may assume that female gender is related with increased mortality in coronary artery surgery for left main disease in the pre-discharge period however after discharge from hospital, long-term benefit of female survivors of coronary artery bypass grafting operated on for left main coronary artery disease might be as good as in men.

Keywords: Left main coronary artery disease, coronary artery bypass surgery, female gender, mortality, Kaplan-Meier analysis

Sol ana koroner arter hastalığı nedeniyle koroner baypas geçiren olgularda kadın cinsiyetin prognoz üzerine etkisi

M. Tuna Katırcıbaşı¹ , H.Tolga Koçum² , Mehmet Baltalı² , Tansel Erol³ , Abdullah Tekin² , Fatma Yiğit² , Göknur Tekin¹ , H. Tarık Kızıltan⁴ , Haldun Müderrisoğlu⁵

¹Department of Cardiology, School of Medicine, Ba?kent University, Ankara, Adana, Turkey
²Department of Cardiology Surgery, School of Medicine, Başkent University, Ankara, Adana, Turkey
³Department of 2Cardiology, Faculty of Medicine, Başkent University, Ankara, Turkey
⁴Department of Cardiovascular Surgery, School of Medicine, Ba?kent University, Ankara, Adana, Turkey
⁵Department of Cardiology, Faculty of Medicine, Başkent University, Ankara, Turkey

The Anatolian Journal of Cardiology 2007; 7(2): 134-139 PMID: 17513207

Anahtar Kelimeler: Sol ana koroner arter hastalığı, koroner baypas cerrahisi, kadn cinsiyet, mortalite, Kaplan-Meier analizi