Male Sex Associated with Increased Long-term Cardiovascular Mortality after Peripheral Vascular Surgery for Atherosclerosis Despite Optimal Medical Treatment.
BACKGROUND
The cardiovascular burden and consequences of peripheral atherosclerosis appear to differ between men and women. Data regarding long-term outcomes, including the impact of medical prophylactic treatment, are insufficient. This study examined long-term outcomes according to sex following primary vascular surgery, adjusted for multiple variables as well as recommended medical prophylaxis.


METHODS
All Danish patients who underwent peripheral vascular surgery from January 2000 to December 2007 were stratified into five procedural groups: (a) aorto-iliac bypass or thromboendarterectomy, (b) femoro-femoral crossover, (c) thromboendarterectomy of the femoral arteries, (d) infrainguinal bypass, or (e) axillo- uni-, and bifemoral bypass. Data were analyzed according to sex for differences in myocardial infarction, stroke, and death, individually and combined, after surgery.


RESULTS
A total of 11,234 patients were included: 6,289 males and 4,945 females. The overall adjusted hazard ratio for male patients compared with female patients for death was 1.11 (95% CI 1.06-1.17), for MI was 1.16 (95% CI 1.04-1.29), for stroke was 0.99 (95% CI 0.89-1.11), and for any major adverse cardiovascular event was 1.10 (95% CI 1.05-1.16).


CONCLUSIONS
These findings show that, despite indication, severity, and concomitant medical treatment of peripheral artery disease, men have a higher risk of mortality and adverse cardiovascular events following surgery for peripheral arterial disease.
['Budtz-Lilly|J W|JW|', 'Petersen|C N|CN|', 'Pedersen|T F|TF|', 'Eldrup|N|N|']
D000368:Aged D000369:Aged, 80 and over D002317:Cardiovascular Agents D002423:Cause of Death D015897:Comorbidity D003718:Denmark D005260:Female D054624:Health Status Disparities D006801:Humans D053208:Kaplan-Meier Estimate D008297:Male D008875:Middle Aged D009203:Myocardial Infarction D058729:Peripheral Arterial Disease D012042:Registries D012189:Retrospective Studies D012307:Risk Factors D012720:Severity of Illness Index D012737:Sex Factors D020521:Stroke D013997:Time Factors D016896:Treatment Outcome D014656:Vascular Surgical Procedures
Sex Mortality Outcomes Peripheral vascular disease