Standard CABG – Pain Killers or Extending Life?

Abstract

During the last decades, several studies have shown improved short- and long-time survival after Coronary Artery Bypass Grafting (CABG). Despite the greater reduction in postoperative mortality, there is still a concern whether cardiac surgery is primarily palliative pain relieving and delaying mortality or offers survival equal to or better than the background population. Method and Results: The study was based on 19,948 single CABG patients performed from 2000-2020, obtained from the mandatory Western Denmark Heart Registry and not previous exposed to cardiac surgery. Overall, the mortality declined from the first to the last 5-year study period, with 63.6% in 1-year mortality and 41.1% in 5-year mortality. Gender perspective evaluation revealed significant differences. The female mortality was, except for the last 5-year period, significantly higher than men (5.21% vs 3.73% in 1-year mortality, P<0.0001), underlined further by men almost balancing the population mortality after 5 years, while females never caught up. Comorbidity and postoperative complications had great negative impact on survival, but even without comorbidity or complications, females constantly showed higher mortality than the female population. Thus, the definitive result showed a remarkable difference between genders, comparing the study group and population 10-year survival, being 69.3% vs 63.8% in men and 64.3% vs 68.8% in females. Conclusions: Females have a substantial higher mortality than males after CABG when compared to the background population. Males seem to catch up with population mortality 4-5 years after surgery, while females continue to have a lower survival than the background population.