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Longer Term Benefits of CABG: The Same for Men and Women?

As reported by Stewart et al.[4] even though women tend to function at a lower level (before and after operation), the enhancement of their functional status after surgery is similar to that seen in men. On the other hand, other studies have reported an increase in the frequency of angina or recurrent MI over time in women. Although specific reasons for such results are still under investigation.

The anticipated suggestions are: incomplete revascularization, decrease graft patency related to small size of distal vessels or acceleration of atherosclerosis in original vessels[5].

In spite of increased recurrence of angina, studies show fewer female patients are referred for repeat revascularization procedures. As for survival success following CABG, men and women tend to have similar success in the recent years. However, long term survival seems connected to other factors such as age, congestive heart failure, diabetes, and peripheral vascular disease rather than gender of the patient[6][7].

Long-term survival and potential benefits of revascularization depend less on sex differences and more on factors such as diabetes, history or hypertension[8]. However, more gender specific research data is necessary prior to drawing concrete conclusions.

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4. Stewart, R.D., Blair, J.L., Emond, C.E., (1999) Gender and Functional Outcome After Coronary Artery Bypass. Surgery, 126: 184-90.

5. Brandrup-Wognsen, G., Berhhren, H., Hartford, M., Hjalmarson. A., Karlsson, T., Herlitz, J., (1996) Female Sex is Associated with Increased Mortality and Morbidity Early But Not Late, After Coronary Artery Bypass Grafting. Eur Heart J, 17:1426-31.

6. Hammer, N., Sandberg, E., Larsen, F.F., Ivert, T., (1997) Comparison of Early and Late Mortality in Men and Women After Isolated Coronary Artery Bypass Graft Surgery in Stockholm, Sweden 1980-1989. J Am Coll Cardiol, 29(3): 659-664.

7. Jacobs, A.K., Brooks, S.F., Mori, M., Faxon, D.P., Chaitman, B.R., Bittner, V., Mock, M.B., Weiner, B.H., Winston, D.L. et al. (1998) Better Outcome For Women Compared With Men Undergoing Coronary Revascularization A Report From the Bypass Angioplasty Revascularization Investigation (BARI). Circulation, 98: 1279-1285.

8. Kells, C., and Mickleborough, L., Revascularization Strategies in Women with Ischemic Heart disease. (2000) Canadian Cardiovascular Society Consensus Conference: Women and Ischemic Heart Disease, October 2000: 8/1-/15.

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