Abstract:
:Background Little attention has been paid to the importance of sex in the long-term prognosis of patients undergoing cardiac surgery. Methods and Results We conducted a retrospective cohort study of Ontario residents, aged ≥40 years, who underwent coronary artery bypass grafting (CABG) and/or aortic, mitral, or tricuspid valve surgery between October 1, 2008, and December 31, 2016. The primary outcome was all-cause mortality. The mortality rate in each surgical group was calculated using the Kaplan-Meier method. The risk of death was assessed using multivariable Cox proportional hazard models. Sex-specific mortality risk factors were identified using multiplicative interaction terms. A total of 72 824 patients were included in the study (25% women). The median follow-up period was 5 (interquartile range, 3-7) years. The long-term age-standardized mortality rate was lowest in patients who underwent isolated CABG and highest among those who underwent combined CABG/multiple valve surgery. Women had significantly higher age-standardized mortality rate than men after CABG and combined CABG/mitral valve surgery. Men had lower rates of long-term mortality than women after isolated mitral valve repair, whereas women had lower rates of long-term mortality than men after isolated mitral valve replacement. We observed a statistically significant association between female sex and long-term mortality after adjustment for key risk factors. Conclusions Female sex was associated with long-term mortality after cardiac surgery. Perioperative optimization and long-term follow-up should be tailored to younger women with a history of myocardial infarction and percutaneous coronary intervention and older men with a history of chronic obstructive pulmonary disease and depression.
journal_name
J Am Heart Assocjournal_title
Journal of the American Heart Associationauthors
Johnston A,Mesana TG,Lee DS,Eddeen AB,Sun LYdoi
10.1161/JAHA.119.013260subject
Has Abstractpub_date
2019-09-03 00:00:00pages
e013260issue
17issn
2047-9980journal_volume
8pub_type
杂志文章abstract::Background Limited data are available on mid-range ejection fraction (mrEF) patients with dilated cardiomyopathy. We sought to define the characteristics, evolution, and long-term prognosis of dilated cardiomyopathy patients with mrEF at diagnosis. Methods and Results We analyzed all dilated cardiomyopathy patients co...
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journal_title:Journal of the American Heart Association
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abstract::See Article Ramkumar et al. ...
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journal_title:Journal of the American Heart Association
pub_type: 杂志文章,多中心研究,随机对照试验
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journal_title:Journal of the American Heart Association
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journal_title:Journal of the American Heart Association
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更新日期:2017-11-07 00:00:00
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更新日期:2020-01-07 00:00:00
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journal_title:Journal of the American Heart Association
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journal_title:Journal of the American Heart Association
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更新日期:2020-11-17 00:00:00
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journal_title:Journal of the American Heart Association
pub_type: 杂志文章
doi:10.1161/JAHA.115.002779
更新日期:2016-04-18 00:00:00
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journal_title:Journal of the American Heart Association
pub_type: 杂志文章
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journal_title:Journal of the American Heart Association
pub_type: 杂志文章,多中心研究,随机对照试验
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更新日期:2018-09-18 00:00:00