Objective: The prognosis of women after acute myocardial infarction (AMI) may be worse compared with men. Only few data exist concerning sex-dependent differences in patients undergoing coronary bypass grafting (CABG) early after AMI.
Methods: Between 2004 and 2014, 855 patients (STEMI: n = 365 (42.7%) and NSTEMI: n = 490 (57.3%)) underwent CABG within 48 hours after diagnosed with AMI. A retrospective, data analysis was performed. In addition, follow-up data was obtained.
Results: Of the 855 patients, 653 (76.4%) were male and 202 (23.6%) were female. Median age in men was 67 (59;74) years and 72 (64;77) years in women (p < 0.001). Female patients significantly more often suffered from arterial hypertension (p < 0.001), Diabetes mellitus (p < 0.001) and obesity (p = 0.036) and they were more often diagnosed with NSTEMI (p = 0.040) than men. The EuroSCORE II was higher in women compared with men (p < 0.001). More women than men had suffered from iatrogenic AMI (p = 0.001) and coronary 1-vessel disease (p = 0.023). Median time to surgery was 6.9 (4.0;15.9) hours for male patients and 8.2 (4.4;18.1) for women (p = 0.154). Women received a smaller number of distal anastomoses (p = 0.001). Post-operatively, transfusion rates were higher in female patients (p < 0.001). They developed significantly more often atrial fibrillation (p = 0.013). No differences in stroke rates were observed. 30-day mortality was n = 63 (10.0%) in men and n = 28 (14.0%) in women, (p = 0.115). After exclusion of patients with cardiogenic shock and resuscitated patients, 30-day mortality was n = 26 (5.5%) for men n = 10 (6.3%) for women (p = 0.714). 10-year survival rate was 59% in men and 51% in women (p = 0.010). Risk factors for 30-day and 1-year mortality in women included age and pre-operative cardiogenic.
Conclusion: This retrospective analysis showed that women with AMI have a significantly higher long-term mortality than men. Age and pre-operative cardiogenic shock were risk factors for 30-day and 1-year mortality of women.
