Recent research from Weill Cornell Medicine sheds light on the heightened risk of mortality for women undergoing heart bypass surgery compared to men.
Published in the Journal of the American College of Cardiology, this study underscores the role of intraoperative anaemia, wherein the loss of red blood cells during surgery significantly influences outcomes.
The findings suggest that proactive measures to mitigate anaemia during these procedures could substantially improve survival rates for women with cardiovascular disease.
The investigation aimed to elucidate the disparities in survival rates between men and women undergoing coronary artery bypass grafting.
The research team, led by senior author Dr Mario Gaudino, the Stephen and Suzanne Weiss Professor in Cardiothoracic Surgery at Weill Cornell Medicine, analysed data from the Society of Thoracic Surgeons Adult Cardiac Surgery Database, encompassing over one million patients.
The study’s first author was Dr Lamia Harik, a fellow in Cardiothoracic Surgery Research at Weill Cornell Medicine.
Examining various patient demographics, risk factors, and surgical parameters, the team confirmed a stark difference in mortality rates between genders, with women exhibiting a 50% higher mortality rate than men.
Further analysis revealed that a significant portion of this heightened risk – 38% – could be attributed to severe intraoperative anaemia, a consequence of the use of blood-diluting fluids in the heart-lung bypass machine utilised during surgery.
Women, due to factors such as lower baseline red blood cell counts and smaller body size, may be particularly susceptible to the adverse effects of intraoperative anaemia.
While the study does not establish a causal relationship between intraoperative anaemia and increased female mortality, it highlights a strong association.
It underscores the importance of exploring interventions to prevent or minimise severe intraoperative anaemia, which can result in compromised oxygen delivery to vital tissues, including the heart.
Potential interventions include the utilisation of heart-lung bypass machines with shorter circuits and reducing the volume of blood-diluting solutions required during surgery.
Dr Gaudino, a cardiovascular surgeon at NewYork-Presbyterian/Weill Cornell Medical Centre, advocates urgent randomised trials to evaluate whether such strategies could effectively improve outcomes for women undergoing heart bypass surgery.
