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Women Less Likely to Undergo Guideline-Concordant CABG

WEDNESDAY, Feb. 3, 2021 -- For patients with coronary artery disease undergoing coronary artery bypass grafting (CABG) surgery, female sex is associated with lower odds of undergoing guideline-concordant revascularization, according to a study presented at the annual meeting of the Society of Thoracic Surgeons, held virtually from Jan. 29 to 31.

Oliver K. Jawitz, M.D., from Duke University in Durham, North Carolina, and colleagues queried the Society of Thoracic Surgeons Adult Cardiac Surgery Database for all adults who underwent first-time isolated CABG in the United States from 2011 to 2019. The authors sought to examine the association between female sex and use of guideline-concordant revascularization techniques.

The researchers found lower unadjusted rates of revascularization with an internal mammary artery (IMA), bilateral IMA, or radial artery graft in association with female sex. Over time, the rates of left IMA (LIMA), bilateral IMA, and radial artery grafting increased; however, there was little change in the differences between men and women. After adjustment, compared with men, women had lower odds of receiving a LIMA graft to the left anterior descending artery, undergoing complete revascularization, and undergoing multi-arterial grafting (adjusted odds ratios, 0.79, 0.86, and 0.78, respectively). For the majority of subgroups, female sex was associated with reduced odds of receiving a LIMA graft, undergoing complete revascularization, and multi-arterial revascularization after controlling for interactions.

"This study highlights key differences between women and men in surgical techniques used for CABG and reveals opportunities to improve outcomes in women," Jawitz said in a statement.

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