What is the clinical evidence from this study?

Study design: Cohort. Population: Single-vessel coronary artery disease (n=350). Intervention: Female sex vs. Male sex. Primary outcome: all-cause long-term mortality (HR 0.80, 95% CI 0.38-1.70, p=0.560).

What does this research mean for the field?

Minimally invasive direct coronary artery bypass (MIDCAB) confers equivalent perioperative safety and long-term survival in women and men, demonstrating that female sex is not an independent predictor of adverse outcomes for this procedure. Novelty: ClaimNovelty.CONFIRMATORY. Consensus alignment: ConsensusAlignment.SUPPORTS_CONSENSUS.

What question did this study set out to answer?

To evaluate sex-specific perioperative complications and long-term survival following minimally invasive direct coronary artery bypass (MIDCAB) in patients with coronary artery disease.

September 5, 2026Journal of Clinical MedicineOpen Access

Sex Disparities in Outcomes After Minimally Invasive Direct CABG for Single-Vessel Disease: A Propensity Score-Matched Analysis

Q: What are the key findings of this study?

Female sex was not associated with increased long-term all-cause mortality after MIDCAB compared to males (12.0% vs 12.0%; adjusted HR 0.80, 95% CI 0.38-1.70, p=0.560).

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Key result

Female sex shows no excess long-term mortality risk compared to males after MIDCAB.

HR 0.80
95% CI 0.38-1.70
P=0.560
n=350

Why the study?

Does female sex confer a higher risk of adverse outcomes and long-term mortality compared to male sex in patients undergoing minimally invasive direct CABG?

Population

350 consecutive patients with single-vessel and LAD-predominant coronary artery disease undergoing minimally…

Comparison

Female sex (undergoing MIDCAB) vs Male sex

Design

Cohort

Follow-up

median 19.0 years (IQR 11.8–23.9)

Authors

LALukman AmanovMedizinische Hochschule Hannover ARArian Arjomandi RadCardiac Surgery SASadeq Ali-Hasan-Al-Saegh

Discussion

Member takes

Implication

Supports MIDCAB as sex-neutral in single-vessel disease; extends observational data but leaves randomized confirmation open.

Key Points

To evaluate sex-specific perioperative complications and long-term survival following minimally invasive direct coronary artery bypass (MIDCAB) in patients with coronary artery disease.
Retrospectively analyzed 350 consecutive patients (102 females, 248 males) undergoing MIDCAB at Hannover Medical School between July 1999 and April 2025 with up to 26 years of follow-up (median 19.0 years).
Performed 1:1 propensity score matching (100 female-male pairs) with standardized mean differences < 0.20, Kaplan-Meier survival analyses, and multivariable Cox proportional hazards regression.
Thirty-day mortality was 0% in both sexes, and all-cause long-term mortality was identical between matched females and males (12.0% vs. 12.0%, p = 1.000; log-rank p = 0.703).
In multivariable Cox regression in the full cohort, female sex was not associated with long-term mortality (adjusted HR 0.80, 95% CI 0.38–1.70, p = 0.560), while age was an independent predictor (HR 1.10 per year, 95% CI 1.05–1.15, p < 0.001).
Perioperative complications were comparable, including new-onset atrial fibrillation (3.0% vs. 1.0%, p = 0.621) and median hospital stay (8 days in both groups), while re-exploration for bleeding occurred in 5.0% vs. 0.0% (p = 0.059).

Study Design

Type

Cohort (n=350)

Multicenter

Structured PICO

Does female sex confer a higher risk of adverse outcomes and long-term mortality compared to male sex in patients undergoing minimally invasive direct CABG?

Population

350 patients undergoing minimally invasive direct coronary artery bypass (MIDCAB) for single-vessel disease, followed for a median of 19.0 years.

Exposure

Female sex (undergoing MIDCAB)

Comparator

Male sex (undergoing MIDCAB, evaluated via 1:1 propensity score matching)

Outcome

All-cause long-term mortalityhard clinical

Main Result

Hazard Ratio: 0.8 (95% CI 0.38–1.7)

Absolute Event Rate: 12% vs 12%

p-value: p=0.560

In patients undergoing minimally invasive direct CABG for single-vessel disease, female sex is not associated with worse perioperative safety or long-term survival compared to men, supporting MIDCAB as a sex-neutral revascularization strategy.

Cite This Study

Amanov et al. (2026) conducted a cohort in Single-vessel coronary artery disease (n=350). Female sex vs. Male sex was evaluated on all-cause long-term mortality (HR 0.80, 95% CI 0.38-1.70, p=0.560). Female sex was not associated with increased long-term all-cause mortality after MIDCAB compared to males (12.0% vs 12.0%; adjusted HR 0.80, 95% CI 0.38-1.70, p=0.560).

synapsesocial.com/papers/6a9bd4346b95aff0620ebb2f https://doi.org/10.3390/jcm15176821

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Sex Disparities in Outcomes After Minimally Invasive Direct CABG for Single-Vessel Disease: A Propensity Score-Matched Analysis

Discussion

Member takes

Implication

Key Points

Study Design

Structured PICO

Main Result

Cite This Study

Sex Disparities in Outcomes After Minimally Invasive Direct CABG for Single-Vessel Disease: A Propensity Score-Matched Analysis

Discussion

Member takes

Implication

Key Points

Study Design

Structured PICO

Main Result

Cite This Study

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