Increased Coronary Artery Disease Severity in Black Women Undergoing Coronary Bypass Surgery

Race and sex disparities are believed to play an importantrole in heart disease. The purpose of this study was to examine theassociation between race, sex, and number of diseased vessels at thetime of coronary artery bypass grafting (CABG), and subsequent postoperative outcomes.The 13,774 patients undergoing first-time, isolated CABG between1992 and 2011 were included. Trend in the number of diseased vesselsbetween black and white patients, stratified by sex, were analyzed usinga Cochran--Armitage trend test. Models were adjusted for age, procedural status (elective vs. nonelective), and payor type (private vs.nonprivate insurance).Black female CABG patients presented with an increasingly greaternumber of diseased vessels than white female CABG patients (adjustedPtrend¼ 0.0021). A similar trend was not observed between black andwhite male CABG patients (adjusted Ptrend¼ 0.18). Black femaleCABG patients were also more likely to have longer intensive careunit and hospital lengths of stay than other race--sex groups.Our findings suggest that black female CABG patients have moreadvanced coronary artery disease than white female CABG patients.Further research is needed to determine the benefit of targeted preventive care and preoperative workup for this high-risk group