Major adverse cardiovascular events—serious problems including heart attack, stroke, repeat heart surgeries, and death—still show stark racial and sex disparities after coronary artery bypass surgery, according to one of the most extensive health system reviews in California.
In more than 7,400 patients followed up to 12 years, “female, Black, and Other (Native American, multiethnic or missing race or ethnicity) groups had the greatest incidence of major adverse cardiovascular events—including heart attack, stroke, and repeat operations.” While survival improved for Asian and South Asian patients, the risk of poor outcomes lingered for Black patients. “Occurrence of any major adverse cardiovascular event was highest in Black individuals (47%) and Other (42.3%) groups, and lowest in South Asian (27.9%) and Other Asian Pacific Islander (29.1%) patients.”
Differences in survival could not be explained by surgical technique or post-operative care alone. The study notes that “Black and Hispanic patients consistently receive less risk reduction counseling or referral to cardiac rehabilitation post bypass surgery compared with White patients, with demonstrated poor long-term survival rates disproportionately affecting younger Black patients.” A heavier burden of risk factors at the time of surgery—such as higher rates of diabetes, kidney disease, high cholesterol, smoking, and urgent surgery status—was pointed out as driving these disparities.
The authors urge that “equitable health education programs, culturally informed care, and long-term surveillance programs may help to reduce drivers of health disparities.” They emphasize the need for better targeting of risk factors and systemic barriers, so vulnerable groups receive the full benefit of advanced cardiac care.
See: “Influence of Sex and Race or Ethnicity on Major Adverse Cardiovascular Outcomes Following Coronary Artery Bypass Surgery” (September 19, 2025)
