Original articleCardiovascularSex-Specific Long-Term Outcomes After Combined Valve and Coronary Artery Surgery
Section snippets
Material and Methods
Perioperative data for all patients undergoing cardiac surgery at the Toronto General Hospital were entered prospectively into a database. A total of 1567 consecutive patients undergoing combined CABG and valve surgery between January 1990 and October 2000 were identified. Long-term follow-up was obtained by linking our clinical database to a governmental administrative hospital discharge registry (the Canadian Institute of Health Information database) and to a governmental registry of deaths
Results
Table 1 shows the perioperative clinical variables in men versus women. Two thirds of patients were men. Women were significantly older and had more preoperative risk factors including hypertension, diabetes mellitus, and congestive heart failure. Women also had more angina and poorer NYHA classification before surgery. The prevalence of preoperative atrial fibrillation was almost twice as high in women (22%) as in men (13%), and the percentage of women who had had a stroke before surgery was
Comment
In the current study, we demonstrated that overall long-term survival is similar for men and women undergoing combined CABG and valvular surgery, despite an increased prevalence of risk factors in female patients. We also demonstrated a significantly increased risk of long-term stroke in women.
Few studies have investigated long-term sex differences in combined valve and CABG surgery [9, 10, 11]. In addition, such studies have been limited by small sample sizes. We previously compared
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