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首页> 外文期刊>Journal of the American College of Cardiology >Worse clinical outcome but similar graft patency in women versus men one year after coronary artery bypass graft surgery owing to an excess of exposed risk factors in women. CABADAS. Research Group of the Interuniversity Cardiology Institute of The N
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Worse clinical outcome but similar graft patency in women versus men one year after coronary artery bypass graft surgery owing to an excess of exposed risk factors in women. CABADAS. Research Group of the Interuniversity Cardiology Institute of The N

机译：由于女性暴露的危险因素过多，临床结果较差，但在女性进行冠状动脉旁路移植手术一年后，男性的移植通畅率与男性相似。卡巴达斯。 N国立大学心脏病学研究所研究组

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OBJECTIVES: This retrospective study sought to assess differences in graft patency and clinical outcome between women and men after coronary artery bypass graft surgery (CABG). BACKGROUND: A less favorable clinical outcome has been reported in women as compared with men. Its relation to graft patency has not been studied. METHODS: We analyzed one-year follow-up data of 912 patients (120 women) who entered a randomized clinical drug trial. All patients received vein grafts; in 494 patients (56 women) internal mammary artery (IMA) grafts were also used. Graft patency was assessed by coronary angiography at one year. Primary clinical end points were myocardial infarction, revascularization procedures and death; secondary clinical end points included recurrent angina, heart failure and arrhythmias. RESULTS: Occlusion rates of vein grafts were 16.7% in women and 12.4% in men (odds ratio [OR] 1.62, 95% confidence interval [CI] 0.88 to 3.00, p = 0.12); occlusion rates of IMA grafts were 3.4% and 5.7% in women and men, respectively (OR 0.56, 95% CI 0.08 to 3.96, p = 0.56). Primary clinical end points were observed in 16.7% of women and 9.2% of men (OR 1.97, 95% CI 1.10 to 3.34, p = 0.022), and any clinical end point in 41.7% of women and 25.8% of men (OR 2.06, 95% CI 1.39 to 3.04, p = 0.0004). Myocardial infarction (15% vs. 7.6%, OR 2.15, 95% CI 1.24 to 3.75, p = 0.013) and recurrent angina (26.7% vs. 15.4%, OR 2.00, 95% CI 1.28 to 3.11, p = 0.004) occurred most frequently. Multivariate regression analysis did not identify gender as an independent risk factor for graft occlusion or the clinical end points. Graft occlusion was an independent predictor of the composite primary clinical end point (OR 2.75, 95% CI 1.59 to 4.75, p = 0.0003) and each of the secondary clinical end points. The observed differences were due to an imbalance of risk factors at baseline and to surgical and graft characteristics. CONCLUSIONS: One-year occlusion rates of vein and IMA grafts were comparable in women and men. Clinical outcome was related to graft patency and was less favorable in women owing to their uneven distribution of risk factors among both groups.
机译：目的：这项回顾性研究旨在评估冠状动脉搭桥术（CABG）后男女之间的通畅性和临床结局的差异。背景：据报道，与男性相比，女性的临床结果较差。尚未研究其与移植物通畅性的关系。方法：我们分析了进入随机临床药物试验的912名患者（120名女性）的一年随访数据。所有患者均接受了静脉移植。在494名患者（56名女性）中，还使用了乳内动脉（IMA）移植物。一年后通过冠状动脉造影评估移植物的通畅性。主要临床终点为心肌梗塞，血运重建程序和死亡。次要临床终点包括复发性心绞痛，心力衰竭和心律不齐。结果：女性的静脉移植物阻塞率为16.7％，男性为12.4％（优势比[OR] 1.62，95％置信区间[CI] 0.88至3.00，p = 0.12）;女性和男性的IMA移植物闭塞率分别为3.4％和5.7％（OR 0.56、95％CI 0.08至3.96，p = 0.56）。观察到主要临床终点的女性为16.7％，男性为9.2％（OR 1.97，95％CI 1.10至3.34，p = 0.022），任何临床终点均为41.7％的女性和25.8％的男性（OR 2.06） ，95％CI 1.39至3.04，p = 0.0004）。发生心肌梗死（15％vs. 7.6％，或2.15，95％CI 1.24至3.75，p = 0.013）和复发性心绞痛（26.7％vs. 15.4％，或2.00，95％CI 1.28至3.11，p = 0.004）最常用。多元回归分析未将性别确定为移植物闭塞或临床终点的独立危险因素。移植物阻塞是复合主要临床终点（OR 2.75，95％CI 1.59至4.75，p = 0.0003）和每个次要临床终点的独立预测因子。观察到的差异归因于基线时危险因素的不平衡以及手术和移植物的特征。结论：一年期静脉和IMA移植物的闭塞率在男女中相当。临床结果与移植物的通畅性有关，并且由于两组之间危险因素的分布不均而对女性不利。

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