Despite more than a decade of advancements in cardiac care and research, women still have a higher risk for death and adverse events after the heart surgery than men, a study of more than 1 million women found.
For the study, which was published in JAMA in March 2023, researchers looked at the outcomes of female and male patients who had coronary artery bypass grafting procedures between 2011 and 2020 discovered a 2.8% mortality rate for women who'd had the procedure compared to 1.7% in men, with "no significant improvement … seen over the course of the last decade," the authors wrote.
They added that the results are a call to action for further research into the determinants of operative outcomes in women.
Coronary artery bypass is one of the most common heart procedures, performed about 200,000 to 300,000 times a year in the U.S., The New York Times reported Jan. 20.
In fact, it is the commonality of the procedure that baffles physicians about the lack of progress the study revealed.
"The general assumption was that it was getting better because the technology, the knowledge, the skills and training were all improving," C. Noel Bairey Merz, MD, a cardiologist and researcher at Cedars-Sinai Medical Center in Los Angeles, told The Times, adding that seeing the inequities continue "is very disappointing."
Now, nearly a year after the JAMA study was published, physicians are calling for more to be done to address the gender disparities in the surgical outcomes, which are by no means "new."
Six more notes on gender disparities in heart surgery:
- Women have different symptoms of coronary artery disease than men.
- The way coronary artery disease presents in men is primarily what medical students study in medical school, Mario Gaudino, MD, PhD, an author of the March 2023 JAMA study and cardiothoracic surgeon at Weill Cornell Medicine, told The Times.
- Fewer than 20% of patients enrolled in heart disease clinical trials have been women, Dr. Gaudino told The Times.
- Another study, published in 2020, found that women also have worse outcomes than men after receiving heart stents.
- While cardiovascular disease mortality has fallen overall, it is decreasing less in women than men.
- Women are also "less likely to be prescribed and to take statins, and particularly less likely to take the high-intensity statins, which are the most lifesaving," Dr. Bairey Merz told The Times.