Women Survive Longer Than Men After Coronary Bypass

TOPLINE:

A meta-analysis of more than 140,000 patients found men and women have similar survival rates during the first decade after undergoing coronary artery bypass grafting (CABG). Beyond 10 years, women show slightly better survival outcomes than men, but both sexes have higher mortality than the general population.  

METHODOLOGY:

• Researchers analyzed all-cause mortality in CABG patients and non-CABG patients from three databases: MEDLINE, ScienceDirect, and the Cochrane Library.
• The analysis included 142,165 patients from eight studies examining long-term (at least 5 years) all-cause mortality as the primary outcome.
• The researchers used the Kaplan-Meier method to calculate all-cause mortality, and Cox proportional hazards regression modeling to compare differences between the groups.

TAKEAWAY:

• Over a 19-year period, men and women who had undergone CABG were more likely to die of any cause than the general population (hazard ratio [HR] for men, 1.14; 95% CI, 1.05-1.23; P = .002; HR for women, 1.21; 95% CI, 1.01-1.47; P = .045).
• Analyses revealed no significant difference in life expectancy compared to the general population in the first 10 years.
• Direct comparison between the sexes showed slightly better survival in women than in men after the 10-year mark (HR for men, 1.04; 95% CI, 1.01-1.08; P = .012).

IN PRACTICE:

“In the first years post-CABG as graft patency is high, CABG seems to provide similar results in men and women,” the researchers reported. “However, in the very long term, with possibly diminishing graft patency, a survival advantage in female patients becomes evident. Beyond menopause, a variety of risk factors are differentially distributed between men and women, which may be associated with longer graft patency. These include smoking, poor diet, lack of physical activity, and alcohol consumption, all of which may contribute longer graft patency in women,” they added.

SOURCE:

The study was led by Hristo Kirov, MD, of the Department of Cardiothoracic Surgery at Friedrich-Schiller-University in Jena, Germany. It was published online on June 11, 2025, in The American Journal of Cardiology.

LIMITATIONS:

The study design had limitations of observational series, including methodological heterogeneity of included studies and residual confounders. Differences in the survival curves after 10 years may be attributed to the lack of long-term follow-up in some of the studies involved in the analysis.

DISCLOSURES:

The authors reported having no relevant financial conflicts of interest.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.