Effect of Gender and Race on Operative Mortality After Isolated Coronary Artery Bypass Grafting

Pollock, Benjamin D.; Hamman, Baron L.; Sass, Danielle; Graca, Briget da; Grayburn, Paul A.; Filardo, Giovanni

doi:10.1016/j.amjcard.2014.12.010

Cited by 13 publications

(5 citation statements)

References 31 publications

(22 reference statements)

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“…Pollock reviewed outcomes at a single center looking for the effects of gender and racial outcomes on isolated CABG performed for 8154 consecutive patients at Baylor University Medical Center [70]. While this study echoed those which previously had shown an increased mortality in female patients compared to males, there was no significant difference in operative mortality between white, African-American, and Hispanic patients.…”

Section: Coronary Artery Bypass Graftingmentioning

confidence: 86%

Ethnic Minorities and Coronary Heart Disease: an Update and Future Directions

Leigh

Alvarez

Rodríguez

2016

Curr Atheroscler Rep

126

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Heart disease remains the leading cause of death in the USA. Overall, heart disease accounts for about 1 in 4 deaths with coronary heart disease (CHD) being responsible for over 370,000 deaths per year. It has frequently and repeatedly been shown that some minority groups in the USA have higher rates of traditional CHD risk factors, different rates of treatment with revascularization procedures, and excess morbidity and mortality from CHD when compared to the non-Hispanic white population. Numerous investigations have been made into the causes of these disparities. This review aims to highlight the recent literature which examines CHD in ethnic minorities and future directions in research and care.

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Section: Coronary Artery Bypass Graftingmentioning

confidence: 86%

Ethnic Minorities and Coronary Heart Disease: an Update and Future Directions

Leigh

Alvarez

Rodríguez

2016

Curr Atheroscler Rep

126

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“…However, several studies have highlighted lower CABG utilization rates and worse post‐CABG mortality among women and racial/ethnic minorities, particularly blacks 3, 4, 5, 6, 7. This awareness has spurred multifaceted local and national interventions aimed at narrowing sex‐ and race‐related differences in CABG use and outcomes 8, 9, 10, 11.…”

Section: Introductionmentioning

confidence: 99%

Sex and Race Differences in the Utilization and Outcomes of Coronary Artery Bypass Grafting Among Medicare Beneficiaries, 1999–2014

Angraal

Khera

Wang

et al. 2018

JAHA

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BackgroundWith over a decade of directed efforts to reduce sex and racial differences in coronary artery bypass grafting (CABG) utilization, and post‐CABG outcomes, we sought to evaluate how the use of CABG and its outcomes have evolved in different sex and racial subgroups.Methods and ResultsUsing data on all fee‐for‐service Medicare beneficiaries undergoing CABG in the United States from 1999 to 2014, we examined differences by sex and race in calendar‐year trends for CABG utilization and post‐CABG outcomes (in‐hospital, 30‐day, and 1‐year mortality and 30‐day readmission). A total of 1 863 719 Medicare fee‐for‐service beneficiaries (33.6% women, 4.6% black) underwent CABG from 1999 to 2014, with a decrease from 611 to 245 CABG procedures per 100 000 person‐years. Men compared with women and whites compared with blacks had higher CABG utilization, with declines in all subgroups. Higher post‐CABG annual declines in mortality (95% confidence interval) were observed in women (in‐hospital, −2.70% [−2.97, −2.44]; 30‐day, −2.29% [−2.54, −2.04]; and 1‐year mortality, −1.67% [−1.88, −1.46]) and blacks (in‐hospital, −3.31% [−4.02, −2.60]; 30‐day, −2.80% [−3.49, −2.12]; and 1‐year mortality, −2.38% [−2.92, −1.84]), compared with men and whites, respectively. Mortality rates remained higher in women and blacks, but differences narrowed over time. Annual adjusted 30‐day readmission rates remained unchanged for all patient groups.ConclusionsWomen and black patients had persistently higher CABG mortality than men and white patients, respectively, despite greater declines over the time period. These findings indicate progress, but also the need for further progress.

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“…Despite recent advances and a multispecialty team‐based approach to the treatment of cardiac arrest, there remains limited and conflicting data with regard to sex‐based disparities in presentation and treatment of patients presenting with a cardiac arrest. There has been ample evidence suggesting that women have worse outcomes across a variety of cardiovascular procedures/surgeries, including coronary artery bypass grafting surgery and primary PCI for ST‐segment elevation myocardial infarction (STEMI) . However, data regarding sex‐based differences in outcomes following cardiac arrest have been conflicting, with some studies showing worse survival among women and others showing comparable or even better survival in women .…”

Section: Introductionmentioning

confidence: 99%

Sex‐Based Disparities in Incidence, Treatment, and Outcomes of Cardiac Arrest in the United States, 2003–2012

Kim

Looser

Swaminathan

et al. 2016

JAHA

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BackgroundRecent studies have shown improving survival after cardiac arrest. However, data regarding sex‐based disparities in treatment and outcomes after cardiac arrest are limited.Methods and ResultsWe performed a retrospective analysis of all patients suffering cardiac arrest between 2003 and 2012 using the Nationwide Inpatient Sample database. Annual rates of cardiac arrest, rates of utilization of coronary angiography/percutaneous coronary interventions/targeted temperature management, and sex‐based outcomes after cardiac arrest were examined. Among a total of 1 436 052 discharge records analyzed for cardiac arrest patients, 45.4% (n=651 745) were females. Women were less likely to present with ventricular tachycardia/ventricular fibrillation arrests compared with men throughout the study period. The annual rates of cardiac arrests have increased from 2003 to 2012 by 14.0% (P trend<0.001) and ventricular tachycardia/ventricular fibrillation arrests have increased by 25.9% (P trend<0.001). Women were less likely to undergo coronary angiography, percutaneous coronary interventions, or targeted temperature management in both ventricular tachycardia/ventricular fibrillation and pulseless electrical activity/asystole arrests. Over a 10‐year study period, there was a significant decrease in in‐hospital mortality in women (from 69.1% to 60.9%, P trend<0.001) and men (from 67.2% to 58.6%, P trend<0.001) after cardiac arrest. In‐hospital mortality was significantly higher in women compared with men (64.0% versus 61.4%; adjusted odds ratio 1.02, P<0.001), particularly in the ventricular tachycardia/ventricular fibrillation arrest cohort (49.4% versus 45.6%; adjusted odds ratio 1.11, P<0.001).ConclusionsWomen presenting with cardiac arrests are less likely to undergo therapeutic procedures, including coronary angiography, percutaneous coronary interventions, and targeted temperature management. Despite trends in improving survival after cardiac arrest over 10 years, women continue to have higher in‐hospital mortality when compared with men.

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Effect of Gender and Race on Operative Mortality After Isolated Coronary Artery Bypass Grafting

Cited by 13 publications

References 31 publications

Ethnic Minorities and Coronary Heart Disease: an Update and Future Directions

Ethnic Minorities and Coronary Heart Disease: an Update and Future Directions

Sex and Race Differences in the Utilization and Outcomes of Coronary Artery Bypass Grafting Among Medicare Beneficiaries, 1999–2014

Sex‐Based Disparities in Incidence, Treatment, and Outcomes of Cardiac Arrest in the United States, 2003–2012

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