Coronary Artery Bypass Grafting in Women A Ten-year Perspective

Abstract

Between Jan. 1974 and Dec. 1983, 3279 patients have undergone isolated coronary artery bypass (CAB) grafting at the Johns Hopkins Hospital [Baltimore, Maryland, USA]. There were 639 women in this group. Women represented 18-22% of the patients having isolated CAB grafting throughout the 10 yr period, except in 1976 when only 13% of the CAB patients were women. Mean age-at-operation for women has increased from 53.9-61.1 yr since 1974, and was higher than the mean operative age of men during each of the 10 yr. Although the oldest woman undergoing CAB grafting in 1974 was 64 yr old, the eldest in 1983 was 84 yr old. Except for an older mean age-at-operation for women and a higher incidence of unstable angina prior to surgery, the only other significant difference in the clinical status of female vs. male CAB patients, detected by a case control analysis, was the smaller body surface area of women compared to men. Although operative mortality was significantly greater for women during most of this review period, mortality was similar during 1983 (2.6% for men vs. 2.4% for women), in spite of a significantly higher incidence of unstable angina in the female group (54% for women vs. 35% for men). The improved survival noted following coronary bypass grafting in women, which occurred in spite of the advancing age of the female group, supports an aggressive approach to surgical intervention in women with severe coronary artery disease.