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BioMed Research International
Volume 2013 (2013), Article ID 108475, 7 pages
http://dx.doi.org/10.1155/2013/108475
Research Article

Detection of Gender Differences in Incomplete Revascularization after Coronary Artery Bypass Surgery Varies with Classification Technique

1Institute of Gender in Medicine, Charité-Universitätsmedizin Berlin, Luisenstraße 65, 10117 Berlin, Germany
2Institute of Medical Psychology, Charité-Universitätsmedizin Berlin, 10117 Berlin, Germany
3Kardiologisches Centrum Frankfurt, 60316 Frankfurt, Germany
4Deutsches Herzzentrum Berlin, 13353 Berlin, Germany
5Center for Cardiovascular Research (CCR), Charité-Universitätsmedizin Berlin, 10117 Berlin, Germany

Received 13 April 2013; Revised 10 June 2013; Accepted 13 June 2013

Academic Editor: Kan Kajimoto

Copyright © 2013 Sabine Oertelt-Prigione et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Background. Incomplete revascularization negatively affects survival after coronary artery bypass surgery (CABG). Since gender and classification technique might impact outcome and reporting, we investigated their effect on revascularization patterns and mortality. Methods. A cohort of bypass patients ( , 23% women) was enrolled prospectively. The degree of revascularization was determined as mathematical difference between affected vessels upon diagnosis and number of grafts or the surgeon’s rating on the case file. Results. Although men displayed more triple-vessel disease, they obtained complete revascularization more frequently than women (85% versus 77%, ). The two calculation methods identified analogous percentages of incompletely revascularized patients, yet there was only a 50% overlap between the two groups. Mathematically, more women, older patients, and patients with NYHA class III/IV appeared incompletely revascularized, while the surgeons identified more patients undergoing technically challenging procedures. Regardless of the definition, incompleteness was a significant risk factor for mortality in both genders (mathematical calculation: HR 2.62, 95% CI 1.76–3.89, ; surgeon: HR 2.04, 95% CI 1.35–3.89, ). Conclusions. Given the differences in identification patterns, we advise that the mathematical calculation be performed after-procedure in all patients regardless of the surgeons’ rating to uncover additional subjects at increased risk.