OUTCOME AFTER CORONARY-ARTERY SURGERY IN WOMEN AND MEN IN THE NORTH OF ENGLAND

We prospectively studied, for 1 year initially, 353 consecutive patien ts (297 male 56 female, 57.2 +/- 7.32 years) with chronic stable angin a admitted for coronary artery bypass graft (CABG) surgery in the Nort h East of England. Patients generally had severe anginal symptoms (med ian 36 months duration) despite anti-anginal therapy (90% taking two o r more anti-anginal drugs). Women were more severely symptomatic than men prior to surgery, despite a similar severity of angiographically-d efined coronary artery disease, suggesting possible referral bias. Wom en were given fewer grafts than men in operations carrying similar ris ks. After surgery, clinical outcome was generally good but women had a higher mortality (12-month mortality 14% in women vs. 6% in men), and higher morbidity in terms of readmissions, angina symptoms, antiangina l drug use and effort tolerance. This series describes clinical practi ce in an area of high coronary disease morbidity and mortality. It ide ntifies the real risks for women with severe symptomatic disease under going coronary artery surgery. We believe it highlights the need for i mproved risk stratification in the treatment of women with angina, and a consideration of alternative treatment strategies for those women d estined to have a poor outcome from CABG.