Long-term outcomes of women compared to men after off-pump coronary artery bypass grafting-a propensity-matched analysis.

Background: Literature is not clear whether women experience increased mortality and adverse events after coronary artery bypass grafting (CABG). Studies have shown that women had comparative outcomes to men in off-pump CABG (OPCAB). Hence, we undertook this study to understand the short- and long-term outcomes of women compared to men after OPCAB.

Methods: Two thousand two hundred patients who underwent OPCAB from November 2014 to December 2021 were included in the study. Median follow-up period was 4.8 years. We performed propensity matching to match 404 women to 404 men.

Results: In the unmatched cohort, women had increased cardiovascular mortality and inferior major adverse cardiovascular and cerebral event (MACCE)-free survival. In the matched cohorts, there was no difference in the 30-day mortality, long-term survival, MACCE-free survival, and cardiovascular mortality between the sexes. Cox proportional hazard showed post-operative renal failure (-value < 0.001; hazard ratio (HR) 11.469) (confidence interval (CI) 2.911-45.180), post-operative stroke (-value 0.023, HR 6.473) (CI 1.295-32.356), EuroSCORE II > 6 (-value 0.022, HR 3.561) (1.204-10.531), emergency surgery (-value 0.022, HR 3.498) (CI 1.202-10.177), and ventilation hours (-value 0.004, HR 3.327) (CI 1.455-7.607) were the risk factors associated with long-term mortality in women.

Conclusion: Our study showed that the increased risk profile of women was the reason for inferior MACCE-free survival and increased cardiovascular mortality in women in the long term after OPCAB. When the risk factors were matched, women had comparable outcomes to men.