Media contacts:
Sherry Baker, 404/377-1398,
Kathi Baker, 404/727-9371,
Janet Christenbury, 404/727-8599,
January 15, 2003


Emory Researchers Find Gender Differences in Bypass Recovery: Social Factors Might Hold Key to Women's Elevated Risk

ATLANTA -- A study published today in the Journal of the American College of Cardiology concludes that women have a more difficult recovery compared with men after coronary artery bypass surgery (CABG) -- and severity of illness, pre-surgery health and other medical factors do not fully explain this gender difference.

The research team of Emory and Yale scientists studied 804 men and 309 women who underwent first CABG at Yale New Haven Hospital between February 1999 and February 2001. The patients were interviewed after surgery between six and eight weeks after their bypass procedures; additional information was obtained from their medical records.

"Although serious post-operative complications were rare, those we noted after discharge, up to six to eight weeks after the surgery -- including readmissions, surgery-related symptoms and side effects and infections -- were more common in women than men," says principal investigator Viola Vaccarino, MD, PhD, of the Emory Department of Medicine's Division of Cardiology. "We also found physical function (PF) remained unchanged and symptoms of depression improved in men, compared to the corresponding levels before surgery. However, in women there was a significant decline in PF and an increase in symptoms of depression following CABG."

According to Dr. Vaccarino, pre-existing conditions and risk factors did not explain the differences in recovery by gender noted in the study. In fact, women actually had fewer diseased coronary arteries than the men. So what could explain the higher rate of problems experienced by women post- CABG? "One possibility is that CABG is a less effective procedure in women compared with men," answers Dr. Vaccarino. "Most previous studies have examined in-hospital mortality and complications, and although results are somewhat divided, several reports have indicated that women have worse outcomes. Few previous studies, however, have looked at a global range of health measures after CABG as we did in this paper. Our results could be in line with a less optimal response from this procedure in women than in men, at least in the short term."

Another possible explanation is that women might have less social and family support than men during their recovery phase, Dr. Vaccarino explains. She points out that more women than men in the study lived alone and were single. In addition, younger women -- who might have more home responsibilities -- tended to have worse outcomes after CABG than older women.

"Some of the problems experienced by the women in the study could be the result of 'overdoing it' during the recovery period and not getting adequate rest or nutrition. Logically, it makes sense that the differences might be due to a combination of home/caregiver responsibilities and lack of help or support," states Dr. Vaccarino. "However, these are things that are difficult to measure."

Dr. Vaccarino believes the study is particularly important because it could help physicians -- and their female patients -- understand areas of vulnerability during the recovery phase following CABG and develop interventions for women to improve recovery. "For example, women might need more social and family support and symptoms of depression should be recognized early and treated," says Dr. Vaccarino.

She adds that more research is needed to further understand the role gender plays in recovering from bypass surgery. "We need to know if differences between men and women during the recovery phase of CABG persist over time. For example, it could be that women take longer to recover, but in the end they catch up. We are now in the process of examining a longer follow-up of these patients to find out," Dr. Vaccarino says.

The Emory Heart Center is comprised of all cardiology services and research at Emory University Hospital (EUH), Emory Crawford Long Hospital (ECLH) Carlyle Fraser Heart Center, the Andreas Gruentzig Cardiovascular Center of Emory University and the Emory Clinic. Ranked in the top ten of U.S. News & World Report's annual survey of the nation's best Heart Centers, the Emory Heart Center has a rich history of excellence in all areas of cardiology -- including education, research and patient care. It is also internationally recognized as one of the birthplaces of modern interventional cardiology.

Return to January Index

For more general information on The Robert W. Woodruff Health Sciences Center
call Health Sciences Communication's Office at 404-727-5686,
or send e-mail to

Copyright © Emory University, 2001. All Rights Reserved.