Females are Associated with Lower Risks of Long-Term Mortality in Patients Undergoing Off-Pump Coronary Artery Bypass Grafting.

Background: In patients who underwent off-pump coronary artery bypass grafting (OPCABG), females were reported to have lower rates of in-hospital mortality rate and postoperative atrial fibrillation than males. However, the association between gender and long-term prognosis following OPCABG is rarely reported.

Objective: This study aims to determine if women benefit more from OPCABG than men by comparing the difference in the risk of long-term all-cause mortality in patients with coronary chronic total occlusion (CTO).

Methods: This is an observational, retrospective cohort study conducted in adult patients (≥18 years) with coronary CTO undergoing OPCABG at our hospital from January 2011 to December 2014. A multivariate Cox proportional hazards model was employed to assess the association of gender with the risk of all-cause mortality. A p-value of <0.05 was considered statistically significant.

Results: Totally 1,256 participants were enrolled, among which 321 (25.6%) were females and 935 (74.4%) were males. During a maximum follow-up of 10 years, the all-cause mortality rate in women was significantly lower than that in men (10.3% vs. 24.3%, p<0.01). Multivariate Cox regression analysis indicated that women were significantly associated with a lower risk of all-cause mortality (HR=0.30, 95% CI: 0.20-0.44; p<0.01) after controlling for potential confounding factors.

Conclusion: Women benefit more from OPCABG surgery than men, as they have a lower risk of long-term all-cause mortality in patients with coronary CTO.