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Women are less likely than men to undergo coronary artery bypass grafting (CABG) using guideline-recommended approaches. This could result in the manifestation of negative outcomes post-surgery.
The findings were published in the journal ‘The Annals of Thoracic Surgery’. It was also presented at the 57th Annual Meeting of The Society of Thoracic Surgeons.
“This study highlights key differences between women and men in surgical techniques used for CABG and reveals opportunities to improve outcomes in women,” said Oliver K. Jawitz, MD, from Duke University in Durham, North Carolina.
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For the study, the researchers used the STS Adult Cardiac Surgery Database, which contains records of nearly all CABG procedures performed in the US and The Johns Hopkins University School of Medicine in Baltimore, Maryland. The researchers identified adult patients who underwent first-time isolated CABG from 2011 to 2019.
Researchers analysed detailed demographic, clinical, and procedural data from more than 1.2 million patients.
The findings showed that women were 14 -22 per cent less likely than men to undergo CABG procedures with these re-vascularisation strategies.
Less aggressive treatment
“With these findings, we did in fact see less aggressive treatment strategies with women. It is clear that sex disparities exist in all aspects of care for patients with coronary artery disease (CAD), including diagnosis, referral for treatment, and now, in surgical approaches to CABG,” added Dr Jawitz.
Dr Jawitz explained that the under treatment of CAD in women largely stems from a failure to recognise key differences in cardiovascular risk factors and symptoms in females compared with males.
Women are much more likely to experience atypical, subtler symptoms of heart disease such as fatigue, abdominal pain, nausea, vomiting, indigestion, and back pain.
Risk factors
Sometimes, women do not even feel the obvious chest pain and pressure that are characteristic of CAD. As far as risk factors, women have their own unique set, including relatively high testosterone levels prior to menopause, increased hypertension during menopause, and higher levels of stress and depression.
In addition, women tend to have a longer time from symptom onset to diagnosis and from diagnosis to medical intervention. Each of these delays allows the disease to worsen over time, increasing the risk for poor surgical outcomes.
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