Abstract 19921: Are Women With Multi-Vessel Coronary Disease Undergoing Coronary Artery Bypass Surgery as Frequently as Men?
Introduction: Observational studies have reported a lower rate of CABG for women v men with multi-vessel CAD. Recent randomized trials have reported better survival for CABG than PCI in this patient population. We reviewed our recent regional experience with coronary revascularization to determine if CABG rates in women are now comparable to those in men among patients with multi-vessel CAD.
Methods: From our regional registries of consecutive coronary revascularizations we identified all patients with 2 or 3 vessel disease (VD) undergoing their first ever PCI or CABG in 2010-2014 (n=7703). Exclusions criteria were: emergent procedures, MI with 24 hours, left main stenosis >50%. Logistic regression was used to adjust for differences in gender that could have influenced the choice of procedure.
Results: Among the study cohort, 26.5% (n=2041) were women. Compared to men, women were older, had a lower BSA, had more comorbidities, more urgent procedures, and had less 3VD. Among 2VD patients (62.9%), rates of CABG were lower for women than men (21.7% v 29.9%, p<0.01) and did not differ by age or procedural priority (Table). Among 3VD patients (37.1%), rates of CABG were also lower for women than men (60.6% v 67.8%, p<0.01) but did differ by age and priority. In a logistic model controlling for age, BSA, DM, PVD, COPD, priority and 3VD, women were 32% less likely to undergo CABG than men (OR 0.68, 95% CI 0.59-0.77).
Conclusions: Rates of CABG v PCI for non-emergent patients with multi-vessel CAD are lower for women than for men. Further study is needed to determine how this observed gender variability is influenced by unmeasured confounding versus patient or physician preferences
Author Disclosures: D.J. Malenka: None. A. Iribarne: None. P.N. Ver Lee: None. Y. Huang: None. B.J. Leavitt: None. E.M. Olmstead: None. A. Eisenhauer: None. J.R. O’Meara: None. P.B. Gogo: None. A.W. DiScipio: None.
- © 2016 by American Heart Association, Inc.