Women have a higher risk of death than men when undergoing heart bypass surgery. Weill Cornell Medicine researchers determined that this disparity is mediated in large part by intraoperative anemia, the loss of red blood cells during surgery.

This study Journal of the American College of Cardiologysuggesting that strategies to minimize the anemia that occurs during this procedure may lead to better outcomes for women with cardiovascular disease.

The study aimed to understand why women are less likely to survive coronary artery bypass grafting, a surgical procedure to restore blood flow to the heart. The team, led by Dr. Mario Gaudino, the Stephen and Suzanne Weiss Professor of Cardiothoracic Surgery at Weill Cornell Medical College, used information on more than 1 million patients from the Society of Thoracic Surgeons’ Adult Cardiac Surgery Database. analyzed. Her Dr. Lamia Harik, a cardiothoracic surgery research fellow at Weill Cornell Medicine, is the paper’s first author.

They examine patient demographics (such as age and ethnicity), risk factors (such as severity of disease, previous heart attacks, and coexisting health conditions), and surgical data (such as time spent on bypass machine and amount of bypass). ) was investigated. blood components such as red blood cells).

Dr. Gaudino and his team have crunched the numbers and previously confirmed that women have a higher mortality rate associated with this procedure than men: 2.8% vs. 1.7%, nearly 50%. There is a difference. Researchers now use sophisticated statistical analysis to evaluate all possible variables and find that a significant portion (38%) of this increased risk can be attributed to severe intraoperative anemia. Did.

This reduction in red blood cells is an inevitable side effect of using blood-thinning fluids during surgery in preparation for the heart-lung bypass machine that takes over the job of pumping blood throughout the body. Women tend to have lower red blood cell counts and are smaller than men before surgery, so they may be more susceptible to intraoperative anemia.

Although this study did not prove that intraoperative anemia caused increased mortality among women, the two factors are related. This study should help clinicians and researchers consider interventions to prevent or minimize severe intraoperative anemia, which can lead to a dangerous reduction in oxygen delivery to body tissues, including the heart. It suggests that.

For example, short-circuit cardiopulmonary bypass machines limit the amount of blood diluent needed to operate the pump. Randomized trials to assess whether methods to control anemia can improve outcomes for women undergoing heart bypass surgery are “urgently needed,” says NewYork-Presbyterian/Weill Cornell Medical Center’s Department of Cardiovascular Medicine. Dr. Gaudino, who is also a surgeon, writes: