Female sex is associated with increased mortality and morbidity early, but not late, after coronary artery bypass grafting

Objective To describe mortality and morbidity during a periodof 2 years after coronary artery bypass grafting in relationto gender. Design Prospective follow-up study. Setting Two regional cardiothoracic centres which performedall the coronary artery bypass operations in western Swedenat the time. Subjects A total of 2129 (1727 (81%) men and 402 (19%) women)consecutive patients undergoing coronary artery bypass surgerybetween June 1988 and June 1991 without concomitant procedures. Results Females were older and more frequently had a historyof hypertension, diabetes mellitus, congestive heart failure,renal dysfunction and obesity. In a multivariate analysis, takingaccount of age, history of cardiovascular diseases and renaldysfunction, female sex appeared as a significant independentpredictor of mortality during the 30 days after coronary arterybypass grafting (P<0.05), but not thereafter. Various postoperative complications including neurological deficit,hydro- and pneumo-thorax, perioperative myocardial damage andthe need for assist devices and prolonged reperfusion were morecommon in females than males. Conclusion Females run an increased risk of early death andthe development of postoperative complications after coronaryartery bypass surgery as compared with males. Late mortalitydoes not appear to be influenced by gender and the long-termbenefit of the coronary artery bypass graft operation is similarin men and women.