Gender related outcome differences in off-pump coronary artery bypass grafting

ObjectivesSurgical myocardial revascularization shows impaired outcomes in women compared to men. Investigation of gender related outcome differences comprises of different operative strategies potentially hampering interpretation of data. We herein aimed to investigate gender related outcome differ...

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Main Authors: Riswan Akram, Friedrich Sobik, Tim Knochenhauer, Sebastian A. Philipp, Jens Brickwedel, Xiaoqin Hua, Beate Reiter, Svante Zipfel, Yvonne Schneeberger, Evaldas Girdauskas, Hermann Reichenspurner, Bjoern Sill, Andreas Schaefer
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-08-01
Series:Frontiers in Cardiovascular Medicine
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Online Access:https://www.frontiersin.org/articles/10.3389/fcvm.2025.1641784/full
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author Riswan Akram
Friedrich Sobik
Tim Knochenhauer
Sebastian A. Philipp
Jens Brickwedel
Xiaoqin Hua
Beate Reiter
Svante Zipfel
Yvonne Schneeberger
Evaldas Girdauskas
Evaldas Girdauskas
Hermann Reichenspurner
Bjoern Sill
Andreas Schaefer
author_facet Riswan Akram
Friedrich Sobik
Tim Knochenhauer
Sebastian A. Philipp
Jens Brickwedel
Xiaoqin Hua
Beate Reiter
Svante Zipfel
Yvonne Schneeberger
Evaldas Girdauskas
Evaldas Girdauskas
Hermann Reichenspurner
Bjoern Sill
Andreas Schaefer
author_sort Riswan Akram
collection DOAJ
description ObjectivesSurgical myocardial revascularization shows impaired outcomes in women compared to men. Investigation of gender related outcome differences comprises of different operative strategies potentially hampering interpretation of data. We herein aimed to investigate gender related outcome differences in off-pump coronary artery bypass grafting (OPCAB) only.MethodsBetween 2016 and 2021, 1,075 consecutive patients underwent OPCAB at our center. Of those 880/1,075 were male (81.9%) and 195/1,075 were female (18.1%). Kaplan–Meier analysis was used for investigating differences in survival probabilities. Identification of risk factors was conducted by logistic regression.ResultsMale patients showed a higher rate of reduced LVEF < 35% (88/880, 10% vs. 9/195, 4.61%; p = 0.025) and impaired renal function (creatinine: 1.17 ± 0.76 vs. 1.03 ± 0.59; p = 0.016). In female patients less utilization of both internal mammary arteries was documented (502/880, 57.04% vs. 74/195, 37.94%; p < 0.001). Procedure time (256.13 min vs. 238.02 min; p < 0.001) and number of distal anastomoses (2.40 ± 0.83 vs. 2.11 ± 0.82; p < 0.001) were lower in female patients. 30-day mortality (16/880, 0.34% vs. 4/195, 0.51%; p = 0.77) and rates of disabling stroke (3/880, 1.81% vs. 1/195, 2.05%; p = 0.55) were similar between groups. In logistic regression analysis age (OR 1.079; CI 1.001- 1.162; p = 0.047) and impaired renal function (OR 1.495; CI 1.090–2.051; p = 0.013) were identified as independent risk factors for 30-day mortality.ConclusionsMale and female patients present similar 30-day outcomes after OPCAB suggesting a potential benefit of OPCAB in female patients. However, female patients receive more saphenous vein grafts compared to men, which may lead to impaired long-term outcomes.
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spelling doaj-art-bc2ba7b85142407085ac83e5d99b92442025-08-20T02:47:32ZengFrontiers Media S.A.Frontiers in Cardiovascular Medicine2297-055X2025-08-011210.3389/fcvm.2025.16417841641784Gender related outcome differences in off-pump coronary artery bypass graftingRiswan Akram0Friedrich Sobik1Tim Knochenhauer2Sebastian A. Philipp3Jens Brickwedel4Xiaoqin Hua5Beate Reiter6Svante Zipfel7Yvonne Schneeberger8Evaldas Girdauskas9Evaldas Girdauskas10Hermann Reichenspurner11Bjoern Sill12Andreas Schaefer13Department of Cardiology, Elbe Clinic Stade, Stade, GermanyDepartment of Cardiovascular Surgery, University Heart and Vascular Center Hamburg, Hamburg, GermanyDepartment of Cardiovascular Surgery, University Heart and Vascular Center Hamburg, Hamburg, GermanyDepartment of Cardiology, Elbe Clinic Stade, Stade, GermanyDepartment of Cardiovascular Surgery, University Heart and Vascular Center Hamburg, Hamburg, GermanyDepartment of Cardiac Surgery, University Hospital Cologne, Cologne, GermanyDepartment of Cardiovascular Surgery, University Heart and Vascular Center Hamburg, Hamburg, GermanyDepartment of Cardiovascular Surgery, University Heart and Vascular Center Hamburg, Hamburg, GermanyDepartment of Cardiac Surgery, Asklepios Clinic St. Georg, Hamburg, GermanyDepartment of Cardiovascular Surgery, University Heart and Vascular Center Hamburg, Hamburg, GermanyDepartment of Cardiothoracic Surgery, Augsburg University Medical Centre, Augsburg, GermanyDepartment of Cardiovascular Surgery, University Heart and Vascular Center Hamburg, Hamburg, GermanyDepartment of Cardiovascular Surgery, University Heart and Vascular Center Hamburg, Hamburg, GermanyDepartment of Cardiovascular Surgery, University Heart and Vascular Center Hamburg, Hamburg, GermanyObjectivesSurgical myocardial revascularization shows impaired outcomes in women compared to men. Investigation of gender related outcome differences comprises of different operative strategies potentially hampering interpretation of data. We herein aimed to investigate gender related outcome differences in off-pump coronary artery bypass grafting (OPCAB) only.MethodsBetween 2016 and 2021, 1,075 consecutive patients underwent OPCAB at our center. Of those 880/1,075 were male (81.9%) and 195/1,075 were female (18.1%). Kaplan–Meier analysis was used for investigating differences in survival probabilities. Identification of risk factors was conducted by logistic regression.ResultsMale patients showed a higher rate of reduced LVEF < 35% (88/880, 10% vs. 9/195, 4.61%; p = 0.025) and impaired renal function (creatinine: 1.17 ± 0.76 vs. 1.03 ± 0.59; p = 0.016). In female patients less utilization of both internal mammary arteries was documented (502/880, 57.04% vs. 74/195, 37.94%; p < 0.001). Procedure time (256.13 min vs. 238.02 min; p < 0.001) and number of distal anastomoses (2.40 ± 0.83 vs. 2.11 ± 0.82; p < 0.001) were lower in female patients. 30-day mortality (16/880, 0.34% vs. 4/195, 0.51%; p = 0.77) and rates of disabling stroke (3/880, 1.81% vs. 1/195, 2.05%; p = 0.55) were similar between groups. In logistic regression analysis age (OR 1.079; CI 1.001- 1.162; p = 0.047) and impaired renal function (OR 1.495; CI 1.090–2.051; p = 0.013) were identified as independent risk factors for 30-day mortality.ConclusionsMale and female patients present similar 30-day outcomes after OPCAB suggesting a potential benefit of OPCAB in female patients. However, female patients receive more saphenous vein grafts compared to men, which may lead to impaired long-term outcomes.https://www.frontiersin.org/articles/10.3389/fcvm.2025.1641784/fullcoronary artery bypass graftingcoronary artery diseasegenderSTEMINSTEMIOPCAB
spellingShingle Riswan Akram
Friedrich Sobik
Tim Knochenhauer
Sebastian A. Philipp
Jens Brickwedel
Xiaoqin Hua
Beate Reiter
Svante Zipfel
Yvonne Schneeberger
Evaldas Girdauskas
Evaldas Girdauskas
Hermann Reichenspurner
Bjoern Sill
Andreas Schaefer
Gender related outcome differences in off-pump coronary artery bypass grafting
Frontiers in Cardiovascular Medicine
coronary artery bypass grafting
coronary artery disease
gender
STEMI
NSTEMI
OPCAB
title Gender related outcome differences in off-pump coronary artery bypass grafting
title_full Gender related outcome differences in off-pump coronary artery bypass grafting
title_fullStr Gender related outcome differences in off-pump coronary artery bypass grafting
title_full_unstemmed Gender related outcome differences in off-pump coronary artery bypass grafting
title_short Gender related outcome differences in off-pump coronary artery bypass grafting
title_sort gender related outcome differences in off pump coronary artery bypass grafting
topic coronary artery bypass grafting
coronary artery disease
gender
STEMI
NSTEMI
OPCAB
url https://www.frontiersin.org/articles/10.3389/fcvm.2025.1641784/full
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