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Older Men Surviving Coronary Bypasses

The survival rate for older men undergoing coronary artery bypass surgery is rising, even though more patients than ever are undergoing the procedure.// Coronary artery bypass surgery uses a blood vessel from another part of the body to reroute blood around narrowed or clogged arteries in the heart. A buildup of substances such as fats or plaque causes this narrowing, known as atherosclerosis.

In the new study, Scottish researchers compared hospital records for 25,229 coronary artery bypass operations performed in Scottish hospitals between 1981 and 1996. Of those surgeries, 78 percent were performed on men and 22 percent on women. "Overall, the total number of operations increased over the period," says Dr. Jill Pell, the study's principal investigator.

While the percentage of bypass surgery also increased in younger patients, the percentage increase in patients over 65 was greatest. The percentage of operations performed on men over 65 rose from 2 percent to 30 percent, while it increased from 16 percent to 45 percent in women older than 65.

Pell found that the risk of death in the two years following surgery fell by 37 percent among men 65 and older. The decrease found in women in the same age range was not large enough to be statistically significant. Pell suspects this was probably due to the smaller number of procedures performed on women.

"The main improvement has been in cardiac surgery, with the increased use of arterial grafts, particularly internal mammary artery grafts," says Pell. "We know that the use of these grafts has increased over that period." Also helping to boost the survival rates, according to Pell, are improvements in "secondary prevention," meaning post-surgical drug treatments and changes in diet, exercise and lifestyle, including quitting smoking.

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