Young
Women At Greater Risk Of Dying After Bypass Surgery Than Men, Emory
Researchers Find
Researchers
have noted that younger women who suffer heart attacks are more likely
to die in the hospital than their male counterparts. Now there's evidence
that younger women are also about three times more likely than men to
die in the hospital following a procedure often performed to prevent
heart attacks – bypass surgery. That's the conclusion reached by a team
of Emory researchers whose findings will be published in the March issue
of Circulation: Journal of the American Heart Association. The research
findings are available beginning February 5 in the Rapid Access online
version of Circulation (http://circ.ahajournals.org/).
"The difference between women
and men is particularly striking in those younger than age 60," says
lead author Viola Vaccarino, M.D., Ph.D., of the Emory Department of
Medicine's Division of Cardiology.
The Emory scientists reviewed
records of 51,187 patients – 15,178 (29.7 percent) of them women – in
the National Cardiovascular Network database who underwent bypass surgery
at 23 medical centers between October 1993 and December 1999. The patients
were divided into five age groups: younger than age 50, 50–59, 60-69,
70–79, and age 80 and older. In patients aged 50-59, women had more
than twice higher risk of in-hospital death following bypass surgery
than men. In patients younger than 50, women had three times higher
mortality rates than men.
"We initially thought that
the higher prevalence of co-existing conditions might be responsible
for the higher rates of in-hospital complications and death in younger
women. For example, diabetes and renal insufficiency were both much
more common in women than in men in this age group," notes Dr. Vaccarino,
associate professor of medicine at Emory's School of Medicine and associate
professor of epidemiology at its Rollins School of Public Health. "However,
we concluded that additional health problems and heart disease risk
factors accounted for less than 30 percent of the mortality differences
between young women and men undergoing bypass."
In fact, women in all age
groups had less severe coronary atherosclerosis, their hearts had better
pumping strength and fewer had already suffered heart attacks than their
male counterparts. " So far, we've been unable to determine what was
responsible for the mortality difference between young men and women
in this study, " says Dr. Vaccarino. "Clearly, further investigation
is needed to find out what factor or factors are responsible."
Coronary artery bypass surgery,
which reroutes blood around clogged arteries to improve the supply of
blood and oxygen to the heart, is performed about 571,000 times each
year in the U.S. Approximately 182,000 women undergo bypass surgery
annually.
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