Arq. Bras. Cardiol. 2025; 122(5): e20240664
Is Female Gender Associated with Mortality in Coronary Artery Bypass Grafting?
Maxim Goncharov
, Erlon Oliveira de Abreu Silva, Pedro Gabriel Melo de Barros e Silva
, Fabiane Letícia de Freitas
, Adriana Costa Moreira, Lucas Tramujas, Alexandre Biasi Cavalcanti, Ieda Maria Liguori, Fabio Biscegli Jatene
, Ieda Biscegli Jatene, Claudia Maria Rodrigues Alves
This Original Article is referred by the Short Editorial "Nothing about Women without Women is for Women".
Abstract
Background
Women undergoing coronary artery bypass grafting (CABG) tend to have worse in-hospital outcomes, but it is unclear whether these differences are due to gender or to clinical factors.
Objective
To compare in-hospital outcomes between women and men undergoing CABG.
Methods
This was a single-center, retrospective observational study analyzing data from 9,845 patients who underwent CABG between 1995 and 2022, of whom 1,947 (19.8%) were women. To evaluate female gender as a prognostic factor for in-hospital mortality, we used descriptive statistics, univariate and multivariate logistic regression, and propensity score matching. The significance level was set at 5%.
Results
Women were older (66.7 vs 62.19 years, p<0.001), had lower body mass index (26.91 vs 27.64, p<0.001), and had a higher prevalence of diabetes mellitus (34.0% vs 31.6%, p=0.045). They also had longer hospital stays (14.84 vs 13.13 days, p<0.001) and higher operative mortality (4.8% vs 2.4%, p<0.001). In logistic regression, female gender was associated with higher mortality (OR=1.51; 95% CI: 1.15-1.99; p=0.003). After matching, there was no significant difference in mortality (OR=1.20; 95% CI: 0.88-1.64; p=0.241), but length of hospital stay remained longer in women.
Conclusion
When clinical factors were matched between men and women, the mortality difference disappeared. This suggests that targeted interventions to reduce disparities may help improve mortality outcomes in women undergoing CABG.
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