Gender differences in coronary artery bypass grafting in acute myocardial infarction

Aim: There is growing interest in treatment and outcome of female patients with coronary artery disease. A lack of information does exist about gender differences on outcome after CABG in patients with acute myocardial infarction. The aim of the study was to examine this scenario during the perioperative course up to thirty days postoperatively. Methods: Between January 2001 and December 2005 275 patients (208 male/ 67 female) with an acute myocardial infarction were treated by CABG (mean age 67±9.4 years). Both genders had the same proportion of pulmonary, renal and gastrointestinal diseases as well as hemodynamic circulatory depression at the time of operation. Results: Follow-up was 97% complete. Thirty-day mortality was statistically not different between male (11.4%) and female (17.2%; p=0.2815). Number of grafts was similar as well as target coronary vessels. There were no differences concerning bypass and operation time, use of IABP intraoperatively, duration of postoperative ventilation. Postoperative complication rate (cerebrovascular accident, bleeding, etc.) and ICU stay were comparable between groups. Value of creatinin was lower in female preoperatively (84.2±36.1 versus 98.6±54.6; p=0.0065) and postoperatively (versus 96.7±43.2 versus 134.9±86.1; p=0.0004) which did not lead to a different percentage of hemofiltration (p=0.6659). Conclusions: Coronary artery bypass grafting is feasible in acute myocardial infarction with acceptable and comparable results in female and male. For receiving a better perioperative outcome there may be the need for earlier diagnostic regarding coronary artery disease especially in women (due to the fact that female present a higher age at time of operation).