Sex and age difference in risk factor distribution, trend, and long-term outcome of patients undergoing isolated coronary artery bypass graft surgery

Babak Sattartabar,Hamideh Mortazavi,Saeed Sadeghian,Jamshid Bagheri,Soheil Mansourian,Kaveh Hosseini,Mina Pashang,Ali Ajam,Arash Jalali,Abbas-Ali Karimi

doi:10.1186/s12872-021-02273-2

Babak Sattartabar, Hamideh Mortazavi + Show 8 more

Open Access

https://doi.org/10.1186/s12872-021-02273-2

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Abstract

BackgroundPreoperative coronary artery disease risk factors (CADRFs) distribution and pattern may also have an important role in determining major adverse cardiovascular events (MACEs). In this study, we aimed to evaluate the CADRFs distribution and trend over 10 years and also the long-term outcome of CABG in different age-sex categories.MethodIn this registry-based serial cross-sectional study, we enrolled 24,328 patients who underwent isolated CABG and evaluated the prevalence of CADRFs according to sex and age. We used inverse probability weighting (IPW) to compare survival and MACE between the sexes. We also used Cox regression to determine each CADRFs effect on survival and MACEs.ResultsIn general, DLP (56.00%), HTN (53.10%), DM (38.40%), and positive family history (38.30%) were the most frequent risk factors in all patients. Prevalence of HTN, DLP, DM, obesity, and positive family history were all higher in women, all statistically significant. The median follow-up duration was 78.1 months (76.31–79.87 months). After inverse probability weighting (to balance risk factors and comorbidities), men had lower MACEs during follow-up (HR 0.72; 95% CI 0.57–0.91; P value 0.006) and there was no significant difference in survival between sexes. DM and HTN were associated with higher mortality and MACEs in both sexes.ConclusionAlthough DLP is still the most frequent CADRF among the CABG population, the level of LDL and TG is decreasing. Women experience higher MACE post CABG. Therefore, health care providers and legislators must pay greater attention to female population CADRFs and ways to prevent them at different levels.

Highlights

Coronary artery disease (CAD) is a chronic, progressive, multifactorial disease that is the leading cause of morbidity and mortality worldwide, especially in developing countries [1, 2]
After inverse probability weighting, men had lower major adverse cardiovascular events (MACEs) during follow-up (HR 0.72; 95% CI 0.57–0.91; P value 0.006) and there was no significant difference in survival between sexes
Health care providers and legislators must pay greater attention to female population coronary artery disease risk factors (CADRFs) and ways to prevent them at different levels

Summary

Introduction

Coronary artery disease (CAD) is a chronic, progressive, multifactorial disease that is the leading cause of morbidity and mortality worldwide, especially in developing countries [1, 2]. Sex and Age are among the most important non-modifiable risk factors, for example, CAD develops in women later in life comparing to men for an unknown reason [6]. Late-onset of CAD in women results in underestimation of cardiovascular risk by healthcare providers and patients [7] and leads to a higher burden of CAD in women, especially at a young age. Preoperative coronary artery disease risk factors (CADRFs) distribution and pattern may have an important role in determining major adverse cardiovascular events (MACEs). We aimed to evaluate the CADRFs distribution and trend over 10 years and the long-term outcome of CABG in different age-sex categories

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