Sex and age difference in risk factor distribution, trend, and long-term outcome of patients undergoing isolated coronary artery bypass graft surgery.
Age Factors
Aged
Coronary Artery Bypass
/ adverse effects
Coronary Artery Disease
/ diagnosis
Cross-Sectional Studies
Female
Health Status Disparities
Heart Disease Risk Factors
Humans
Iran
/ epidemiology
Male
Middle Aged
Prevalence
Registries
Risk Assessment
Sex Factors
Time Factors
Treatment Outcome
Cardiovascular risk factor
Coronary artery bypass graft surgery
Inverse probability weighting
Journal
BMC cardiovascular disorders
ISSN: 1471-2261
Titre abrégé: BMC Cardiovasc Disord
Pays: England
ID NLM: 100968539
Informations de publication
Date de publication:
23 09 2021
23 09 2021
Historique:
received:
13
06
2021
accepted:
20
09
2021
entrez:
24
9
2021
pubmed:
25
9
2021
medline:
18
1
2022
Statut:
epublish
Résumé
Preoperative coronary artery disease risk factors (CADRFs) distribution and pattern may also have an important role in determining major adverse cardiovascular events (MACEs). In this study, we aimed to evaluate the CADRFs distribution and trend over 10 years and also the long-term outcome of CABG in different age-sex categories. In this registry-based serial cross-sectional study, we enrolled 24,328 patients who underwent isolated CABG and evaluated the prevalence of CADRFs according to sex and age. We used inverse probability weighting (IPW) to compare survival and MACE between the sexes. We also used Cox regression to determine each CADRFs effect on survival and MACEs. In general, DLP (56.00%), HTN (53.10%), DM (38.40%), and positive family history (38.30%) were the most frequent risk factors in all patients. Prevalence of HTN, DLP, DM, obesity, and positive family history were all higher in women, all statistically significant. The median follow-up duration was 78.1 months (76.31-79.87 months). After inverse probability weighting (to balance risk factors and comorbidities), men had lower MACEs during follow-up (HR 0.72; 95% CI 0.57-0.91; P value 0.006) and there was no significant difference in survival between sexes. DM and HTN were associated with higher mortality and MACEs in both sexes. Although DLP is still the most frequent CADRF among the CABG population, the level of LDL and TG is decreasing. Women experience higher MACE post CABG. Therefore, health care providers and legislators must pay greater attention to female population CADRFs and ways to prevent them at different levels.
Sections du résumé
BACKGROUND
Preoperative coronary artery disease risk factors (CADRFs) distribution and pattern may also have an important role in determining major adverse cardiovascular events (MACEs). In this study, we aimed to evaluate the CADRFs distribution and trend over 10 years and also the long-term outcome of CABG in different age-sex categories.
METHOD
In this registry-based serial cross-sectional study, we enrolled 24,328 patients who underwent isolated CABG and evaluated the prevalence of CADRFs according to sex and age. We used inverse probability weighting (IPW) to compare survival and MACE between the sexes. We also used Cox regression to determine each CADRFs effect on survival and MACEs.
RESULTS
In general, DLP (56.00%), HTN (53.10%), DM (38.40%), and positive family history (38.30%) were the most frequent risk factors in all patients. Prevalence of HTN, DLP, DM, obesity, and positive family history were all higher in women, all statistically significant. The median follow-up duration was 78.1 months (76.31-79.87 months). After inverse probability weighting (to balance risk factors and comorbidities), men had lower MACEs during follow-up (HR 0.72; 95% CI 0.57-0.91; P value 0.006) and there was no significant difference in survival between sexes. DM and HTN were associated with higher mortality and MACEs in both sexes.
CONCLUSION
Although DLP is still the most frequent CADRF among the CABG population, the level of LDL and TG is decreasing. Women experience higher MACE post CABG. Therefore, health care providers and legislators must pay greater attention to female population CADRFs and ways to prevent them at different levels.
Identifiants
pubmed: 34556032
doi: 10.1186/s12872-021-02273-2
pii: 10.1186/s12872-021-02273-2
pmc: PMC8461921
doi:
Types de publication
Journal Article
Observational Study
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
460Informations de copyright
© 2021. The Author(s).
Références
J Opioid Manag. 2009 Nov-Dec;5(6):365-72
pubmed: 20073410
Coron Artery Dis. 2018 Dec;29(8):657-662
pubmed: 30308587
Eur J Prev Cardiol. 2020 Dec;27(19):2308-2310
pubmed: 31856603
J Thorac Cardiovasc Surg. 2012 Feb;143(2):273-81
pubmed: 22248680
J Am Coll Cardiol. 2015 Nov 3;66(18):1949-1957
pubmed: 26515996
Int Heart J. 2017 Aug 3;58(4):475-480
pubmed: 28717115
Eur J Cardiothorac Surg. 2020 May 1;57(5):986-993
pubmed: 31819982
Pharmacotherapy. 2012 Mar;32(3):222-33
pubmed: 22392455
JAMA Surg. 2015 Apr;150(4):308-15
pubmed: 25671647
Eur Cardiol. 2017 Aug;12(1):10-13
pubmed: 30416543
Vasc Health Risk Manag. 2019 May 01;15:89-100
pubmed: 31118651
Sci Rep. 2017 Oct 18;7(1):13461
pubmed: 29044139
Biomedicine (Taipei). 2020 Dec 01;10(4):23-28
pubmed: 33854931
Lancet Diabetes Endocrinol. 2019 Nov;7(11):866-879
pubmed: 31422063
J Am Heart Assoc. 2019 Jul 16;8(14):e012178
pubmed: 31280642
Eur Heart J. 2018 Aug 1;39(29):2695-2696
pubmed: 30289514
Biomed Res Int. 2017;2017:9829487
pubmed: 29423414
Am J Cardiol. 1976 Jul;38(1):46-51
pubmed: 132862
Eur J Prev Cardiol. 2020 Dec;27(18):1996-2003
pubmed: 32673508
Circulation. 1994 Jul;90(1):583-612
pubmed: 8026046
J Thorac Dis. 2018 Mar;10(3):1960-1967
pubmed: 29707352
Atherosclerosis. 2015 Jul;241(1):284-8
pubmed: 25731671
Eur J Cardiothorac Surg. 2010 May;37(5):1068-74
pubmed: 20036136
Sci Rep. 2019 Jun 12;9(1):8567
pubmed: 31189989
Nutrition. 2020 Apr;72:110696
pubmed: 32007807
Addict Health. 2013 Summer-Autumn;5(3-4):140-53
pubmed: 24494171
Eur J Cardiothorac Surg. 2008 Aug;34(2):370-5
pubmed: 18539474
Indian Heart J. 2017 Jul - Aug;69(4):532-538
pubmed: 28822527
J Thorac Cardiovasc Surg. 2014 May;147(5):1517-23
pubmed: 23870152
Am Heart J. 2004 Jul;148(1):7-15
pubmed: 15215786
Sci Rep. 2020 Jul 16;10(1):11724
pubmed: 32678170
Lancet. 2004 Sep 11-17;364(9438):937-52
pubmed: 15364185
Circulation. 2016 Aug 9;134(6):441-50
pubmed: 27502908
Open Heart. 2020 Mar 17;7(1):e001163
pubmed: 32206316