Turnabout: Women do as well as men after surgery
Focus on Women and Cardiac Care
Turnabout: Women do as well as men after surgery
Bypass surgery and angioplasty equally safe
In surprising contrast to previous research, new findings from a major clinical trial supported by the National Heart, Lung, and Blood Institute (NHLBI) reveal that women undergoing coronary artery bypass surgery (CABG) or balloon angioplasty procedures survive just as well as men.1 The Bypass Angioplasty Revascularization Investigation (BARI) study found no differences in in-hospital deaths and five-year survival between men and women — 88% and 87% respectively. However, because women tend to go into the procedure with less favorable risk profiles than men, their risk-adjusted outcomes following these interventions are actually better. Women in the BARI study were older and had a greater incidence of congestive heart failure (CHF), high blood cholesterol, hypertension, diabetes mellitus, and unstable angina.
"This is good news for women with heart disease who may have been concerned about reports that they were at greater risk than men for these procedures," said NHLBI director Claude Lenfant, MD. Previous research on revascularization procedures has shown higher rates of death and complications among women compared to men.
The BARI study randomly assigned nearly 2,000 patients to either bypass surgery or angioplasty. Twenty-seven percent of the BARI participants were women and 73% were men. The main results, published in 1996, found that both angioplasty and CABG are effective and result in similar mortality rates. The new study found that not only were long-term survival rates comparable for men and women but so were in-hospital survival rates.
In 1995, the NHLBI issued a clinical alert to physicians on results from BARI which found that patients with diabetes who were treated with CABG had a markedly lower death rate after five years than similar patients treated with angioplasty. The new study did not find a significant difference in survival between the two treatment strategies among women with diabetes. According to the study authors, this may be due to the relatively small number of women with diabetes compared to men.
Reference
1. Jacobs AK, Kelsey SF, Brooks MM, et al. Better outcome for women compared with men undergoing coronary revascularization: A report from the Bypass Angioplasty Revascularization Investigation (BARI). Circulation 1998; 98(13):1,279-1,285.
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