Single versus multiple arterial coronary artery bypass grafting in men and women: Results from Polish National Registry of Cardiac Surgery Procedures.

Journal

International journal of surgery (London, England)
ISSN: 1743-9159
Titre abrégé: Int J Surg
Pays: United States
ID NLM: 101228232

Informations de publication

Date de publication:
06 Feb 2024
Historique:
received: 14 11 2023
accepted: 24 01 2024
medline: 7 2 2024
pubmed: 7 2 2024
entrez: 7 2 2024
Statut: aheadofprint

Résumé

The objective of this multicenter study aimed to investigate the impact of sex on long-term survival among patients with multivessel coronary artery disease undergoing coronary artery bypass grafting(CABG) using multiple arterial grafting (MAG) or a single artery with saphenous vein grafts (SAG). Data were obtained from the Polish National Registry of Cardiac Surgery Procedures database. This study included 81,136 patients who underwent CABG for multivessel disease between January 2012 and December 2020 (22.9% were women and 77.1% were men). MAG was performed in 8.3% and 11.7% of female and male patients, respectively. A 1:1 propensity score (PS)-matching was performed. Long-term mortality was compared between matched groups of men and women. Subgroup analyses of patients aged <70 and ≥70 years, with an ejection fraction (EF) >40% and ≤40%, and with and without diabetes, obesity, peripheral artery disease (PAD), or chronic lung disease (CLD) were performed separately in women and men. MAG was associated with lower long-term mortality than SAG in 1,528 PS-matched female pairs (hazard ratio [HR]: 0.74; 95% confidence interval [CI]: 0.59-0.92; P = 0.007) and 7,283 PS-matched male pairs (HR: 0.80; 95% CI: 0.72-0.88; P <0.001). Subgroup analyses confirmed the results among female patients aged <70 years, with diabetes and EF >40%, and without PAD or CLD, and of male patients aged <70 and ≥70 years; with EF >40%; with or without diabetes, obesity, or PAD; and without CLD. In patients undergoing CABG, MAG was associated with significantly improved survival in both sexes. The long-term benefits of MAG observed across subgroups of men and women support the consideration of a multi-arterial revascularization strategy for a broader spectrum of patients.

Sections du résumé

BACKGROUND BACKGROUND
The objective of this multicenter study aimed to investigate the impact of sex on long-term survival among patients with multivessel coronary artery disease undergoing coronary artery bypass grafting(CABG) using multiple arterial grafting (MAG) or a single artery with saphenous vein grafts (SAG).
MATERIALS AND METHODS METHODS
Data were obtained from the Polish National Registry of Cardiac Surgery Procedures database. This study included 81,136 patients who underwent CABG for multivessel disease between January 2012 and December 2020 (22.9% were women and 77.1% were men). MAG was performed in 8.3% and 11.7% of female and male patients, respectively. A 1:1 propensity score (PS)-matching was performed. Long-term mortality was compared between matched groups of men and women. Subgroup analyses of patients aged <70 and ≥70 years, with an ejection fraction (EF) >40% and ≤40%, and with and without diabetes, obesity, peripheral artery disease (PAD), or chronic lung disease (CLD) were performed separately in women and men.
RESULTS RESULTS
MAG was associated with lower long-term mortality than SAG in 1,528 PS-matched female pairs (hazard ratio [HR]: 0.74; 95% confidence interval [CI]: 0.59-0.92; P = 0.007) and 7,283 PS-matched male pairs (HR: 0.80; 95% CI: 0.72-0.88; P <0.001). Subgroup analyses confirmed the results among female patients aged <70 years, with diabetes and EF >40%, and without PAD or CLD, and of male patients aged <70 and ≥70 years; with EF >40%; with or without diabetes, obesity, or PAD; and without CLD.
CONCLUSIONS CONCLUSIONS
In patients undergoing CABG, MAG was associated with significantly improved survival in both sexes. The long-term benefits of MAG observed across subgroups of men and women support the consideration of a multi-arterial revascularization strategy for a broader spectrum of patients.

Identifiants

DOI: 10.1097/JS9.0000000000001133 PMID: 38324262
pubmed: 38324262
doi: 10.1097/JS9.0000000000001133
pii: 01279778-990000000-01028
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Investigateurs

Boguslaw Kapelak (B)
Piotr Kolsut (P)
Piotr Suwalski (P)
Marek Jasinski (M)
Roman Przybylski (R)
Jacek Skiba (J)
Ryszard Stanislawski (R)
Pawel Kwinecki (P)
Remigiusz Tomczyk (R)
Grzegorz Religa (G)
Edward Pietrzyk (E)
Leszek Gryszko (L)
Krzysztof Wrobel (K)
Lukasz Tulecki (L)
Krzysztof Jarmoszewicz (K)
Kamil Karpeta (K)
Piotr Zelazny (P)
Mariusz Kusmierczyk (M)
Marian Burysz (M)
Janusz Stazka (J)
Marian Zembala (M)

Informations de copyright

Copyright © 2024 The Author(s). Published by Wolters Kluwer Health, Inc.

Auteurs

Sleiman Sebastian Aboul-Hassan (SS)

Department of Cardiac Surgery, Zbigniew Religa Heart Center "Medinet", Nowa Sol, Poland.
Department of Cardiac Surgery and Interventional Cardiology, Faculty of Medicine and Medical Sciences, University of Zielona Gora, Zielona Gora, Poland.

Grzegorz Hirnle (G)

Department of Cardiac Surgery, Transplantology, Vascular and Endovascular Surgery, Medical University of Silesia in Katowice, Silesian Centre for Heart Diseases, Zabrze, Poland.

Bartlomiej Perek (B)

Department of Cardiac Surgery and Transplantology, Chair of Cardio-Thoracic Surgery, Poznan University of Medical Sciences, Poznan, Poland.

Marek Jemielity (M)

Department of Cardiac Surgery and Transplantology, Chair of Cardio-Thoracic Surgery, Poznan University of Medical Sciences, Poznan, Poland.

Tomasz Hirnle (T)

Department of Cardiac Surgery, Medical University of Bialystok, Bialystok, Poland.

Miroslaw Brykczynski (M)

Department of Cardiac Surgery, Zbigniew Religa Heart Center "Medinet", Nowa Sol, Poland.
Department of Cardiac Surgery and Interventional Cardiology, Faculty of Medicine and Medical Sciences, University of Zielona Gora, Zielona Gora, Poland.

Marek Deja (M)

Department of Cardiac Surgery, Medical University of Silesia, Katowice, Poland.

Jan Rogowski (J)

Department of Cardiac and Vascular Surgery, Medical University of Gdansk, Gdansk, Poland.

Marek Cisowski (M)

Department of Cardiac Surgery, University Hospital, Institute of Medical Sciences, University of Opole, Opole, Poland.

Michal Krejca (M)

Department of Cardiac Surgery, Chair of Cardiology and Cardiac Surgery, Medical University of Lodz, Lodz, Poland.

Lech Anisimowicz (L)

Department of Cardiac Surgery, Collegium Medium, Nicolaus Copernicus University, Bydgoszcz, Poland.

Kazimierz Widenka (K)

Department of Cardiac Surgery, University of Rzeszow, Rzeszow, Poland.

Witold Gerber (W)

Department of Cardiac Surgery, American Heart of Poland, Bielsko-Biała, Poland.

Jerzy Pacholewicz (J)

Department of Cardiac Surgery, Pomeranian Medical University, Szczecin, Poland.

Pawel Bugajski (P)

Department of Cardiac Surgery, J. Strus Hospital, Poznan, Poland.
Faculty-of-Health-Sciences,-University-of-Medical-Sciences,-Poznan,-Poland.

Piotr Stepinski (P)

Department of Cardiac Surgery, Chair of Cardiology and Cardiac Surgery, Medical University of Lodz, Lodz, Poland.

Bohdan J Maruszewski (BJ)

Department-of-Pediatric-Cardiothoracic-Surgery,-The-Children's-Memorial-Health-Institute, Warsaw,-Poland.

Romuald Cichon (R)

Department of Cardiac Surgery, Zbigniew Religa Heart Center "Medinet", Nowa Sol, Poland.
Department of Cardiac Surgery and Interventional Cardiology, Faculty of Medicine and Medical Sciences, University of Zielona Gora, Zielona Gora, Poland.

Tomasz Hrapkowicz (T)

Department of Cardiac Surgery, Transplantology, Vascular and Endovascular Surgery, Medical University of Silesia in Katowice, Silesian Centre for Heart Diseases, Zabrze, Poland.

Classifications MeSH