The influence of gender on both early and long-term outcomes of coronary artery bypass grafting (CABG) is not clearly defined. Objectives: This study aimed to assess the impact of gender on early and long-term mortality after CABG using data from the KROK Registry. Methods: All 133,973 adult patients who underwent CABG in Poland between 1 January 2009 and 31 December 2019 were included in the Polish National Registry of Cardiac Surgical Procedures (KROK Registry). The study enrolled 90,541 patients: 68,401 men (75.55%) and 22,140 women (24.45%) who met the inclusion criteria. Then, 30-day mortality, 1-year mortality, and long-term mortality rates were compared. Results: Advanced age, higher Canadian Cardiovascular Society (CCS) and New York Heart Association (NYHA) grade, diabetes, hypercholesterolemia, arterial hypertension, body mass index BMI > 35 kg/m², and renal failure, before the propensity matching, were more frequently observed in women. Women more frequently underwent urgent surgery, including single and double graft surgery, and off-pump CABG (OPCAB) (p < 0.001). In propensity-matched groups, early mortality (30 days) was significantly higher in women (3.4% versus 2.8%, p < 0.001). The annual mortality remained higher in this group (6.6% versus 6.0%, p = 0.025). However, long-term mortality differed significantly between the groups and was higher in the male group (33.0% men versus 28.8% women, p < 0.001). Conclusions: There are no apparent differences in long-term mortality between the two sexes in the entire population. In propensity-matched patients, early mortality was lower for men, but the long-term survival was found to be better in women.

Early mortality in the emergency group was higher, while long-term mortality did not differ among the groups. Postoperative ARF is a critical predictor of mortality in both groups.

Platelet endothelial cell adhesion molecule 1 (PECAM-1) is considered an antiplatelet molecule. Previously, we introduced a new parameter called the PECAM-1/thrombus ratio, which indicates the proportion of PECAM-1 in the thrombus and provides a precise description of human platelet activity (in vitro). The aim of this study was to determine whether the PECAM-1/thrombus ratio could serve as a predictive factor for bleeding events during off-pump coronary artery bypass grafting (OPCAB). To achieve this, we collected blood samples from 20 patients scheduled to undergo OPCAB surgery. We assessed the PECAM-1/thrombus ratio by evaluating thrombus formation on collagen fibers under flow conditions. Subsequently, we compared the ability of the PECAM-1/thrombus ratio in predicting bleeding risk with other methods that evaluate hemostasis activity. These methods included assessing platelet P-selectin secretion, platelet exposure of phosphatidylserine, plasma coagulation and fibrinolysis system activity, and thrombus formation using the T-TAS assay. Our findings revealed a positive correlation between the PECAM-1/thrombus ratio and the amount of blood component units transfused (BCUT) during the OPCAB surgery. Furthermore, BCUT did not show any significant correlation with other measured hemostasis parameters. This preliminary study suggests that the PECAM-1/thrombus ratio might be a good predictor of bleeding risk during the OPCAB procedure.

Objective: The aim of this study was to evaluate the impact of coronary bypass surgery (CABG) on long-term mortality, comparing survival rates to those of the general population in Poland. Methods: The study was based on the Polish National Register of Cardiothoracic Surgical Procedures (KROK). Between January 2009 and December 2019, 133,973 patients underwent CABG. The study included all patients who underwent primary CABG. After excluding reoperations and patients with missing key data, there were 132,760 remaining patients who participated in the study. In order to compare patients who underwent CABG with the general population, data from Polish life expectancy tables from the Central Statistical Office (CSO) were used. Results: In the general population (GP), there is a consistent decrease in survival for both women and men throughout the entire observation period. The decline in survivability is more pronounced in the male group. Unlike the CABG group, which is at risk of perioperative mortality, there is no initial drop in survivability in the GP. The early mortality rate in CABG group within 30 days was significantly higher in the group of women than in men (3.51% compared to 2.19%, p < 0.001). The annual mortality rate was higher in the group of women (6.7% vs. 5.14%), and survival time was shorter (345.5 ± 0.4 vs. 351.2 ± 0.2 days, p < 0.001). However, the total mortality over a 13-year period of observation did not differ significantly between the groups (30.17% for women vs. 29.6% for men, p = 0.996) with survival time 10.08 ± 0.02 years in men vs. 10.06 ± 0.03 in women, p = 0.996. Conclusions: CABG surgery equalizes the probability of survival between genders. In long-term observation men have a greater survival benefit than women if compared to the predicted survival of the general population. These observations may provide a new perspective on the choice of revascularization strategy in relation to gender.

Nieoperacyjne zamykanie ubytku w przegrodzie międzyprzedsionkowej (ang. atrial septal defect , ASD) uważa się za skuteczną i bezpieczną metodę leczenia, a istotne powikłania zdarzają się rzadko. Przedmiotem doniesienia jest przypadek pacjentki z chorobą wieńcową, 2 lata po...