Sex-Specific Differences in Early Occlusion Rate After Coronary Artery Bypass Grafting

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BACKGROUND: This study assessed whether there is a difference in early bypass graft occlusion rates after coronary artery bypass grafting (CABG) between men and women. METHODS: Consecutive adult patients undergoing isolated CABG surgery were included. Bypass graft patency was assessed in a postoperative electrocardiogram-gated coronary bypass computed tomography heart scan before discharge. Follow-up data included mortality, major adverse cardiac and cerebrovascular events, rehospitalizations, and cardiac reinterventions. RESULTS: The study included 589 patients (mean, 67 years; SD, 9.4 years), of whom 95 (16%) were women. Bypass graft occlusion was detected in 45 of 589 patients (7.6%) and was seen significantly more often in female patients compared with male patients (n = 13 [14%] vs n = 32 [6.5%], P = .02). This resulted in 14 of 292 (4.8%) and 35 of 1690 (2.1%) occluded grafts (P < .01), respectively. Female sex was significantly associated with higher odds of graft occlusion (odds ratio, 2.6; 95% CI, 1.1-5.7; P = .02). During the median follow-up of 14.5 months (interquartile range, 13.3-16.5 months) in 292 patients, overall mortality was 3.1% (n = 9), with higher incidence of rehospitalizations (28% vs 4.1%, P = .01) and reinterventions (28% vs 2.6%, P < .01) observed in patients with occluded grafts. No statistically significant differences in follow-up outcomes were observed between male and female patients. CONCLUSIONS: Early bypass graft occlusion, detected through standardized postoperative computed tomography scans before discharge, occurred significantly more frequently in female patients compared with male patients after isolated CABG surgery.

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