Abstract
Introduction. In recent years there have been studies conducted to perform a more profound analysis of the reasons for increased risk of coronary artery bypass graft surgery in female population based on the investigation of the influence of such factors as age, comorbidities and type of surgery on hospital mortality. In this regard the objective of our study is the complex evaluation of female gender as an inherent factor of surgical risk of coronary artery bypass grafting considering all major risk factors of this surgery.
Material and methods. Immediate results of surgical treatment for coronary artery disease (CAD) were examined in 160 women. The mean age of patients was 59.2±8.3 years. On-pump coronary artery bypass graft surgery was performed for all the patients.
Results. We didn't reveal any statistically significant difference in hospital mortality rates between women and men (6.9% vs. 3.6%, р=0.07). Multivariate logistic regression analysis detected 8 major risk factors for women (p=0.01): age, presence of 3 or more risk factors in the same patient, multifocal atherosclerosis, luminal diameter of coronary arteries less than 2 mm, type 2 diabetes, left ventricular aneurysm, stenosis of the left main coronary artery, kidney failure. The four first risk factors were the most important ones. It was established that in-hospital mortality was directly related to the number of risk factors in the same patient. Thus, hospital mortality in group of women who had not more than 2 risk factors, was 2.2%, whereas in group of women having 3 and more risk factors – 12.8%.
Conclusion. Female gender is not a surgical risk factor. However, with aging and an increase of a number of additional surgical risk factors for each patient the degree of risk associated with coronary artery bypass graft surgery grows. Therefore a measure of risk associated with surgery in women who are candidates for coronary artery bypass grafting (CABG) must be evaluated individually considering all factors listed above.
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