Are there different complication risks for men and women after coronary artery bypass grafting?

Coronary artery bypass grafting (CABG) is a common heart surgery. Research shows that men and women face different risks. Women tend to have higher rates of death soon after surgery, but long-term survival may be similar or even better for women. The type of complications also differs between sexes.

What the research says

A large study from Israel found that women had higher 30-day mortality after CABG compared to men (odds ratio 2.47) ⁷. However, long-term survival varied by condition: women with heart attack had higher 10-year mortality, but those with unstable angina had similar outcomes to men ⁷. A Finnish registry study of over 14,000 patients found that after adjusting for other factors, all-cause mortality was lower in women (hazard ratio 1.20 for men), while cardiovascular death rates were similar ⁸. Women had more heart attacks during follow-up, but stroke rates were comparable ⁸. Regarding graft choice, a Dutch study of 14,196 patients showed that using the right internal thoracic artery versus the radial artery as a second graft did not affect long-term survival in either sex, but complication patterns differed: postoperative arrhythmias were more common with the right internal thoracic artery in both sexes, while the radial artery was linked to more repeat revascularization in men and more cerebrovascular events in women ⁴.

What to ask your doctor

• What is my personal risk of complications after CABG based on my sex and other health factors?
• Are there differences in how my recovery or long-term outlook might be affected by my sex?
• Which type of bypass graft is recommended for me, and does my sex influence that choice?
• How does my condition (stable angina vs. recent heart attack) affect my risks as a man or woman?
• What can I do to reduce my specific risks before and after surgery?