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Research Article | DOI: https://doi.org/10.31579/2693-2156/158
Department of cardiovascular surgery of Mohamed Abderrahmani specialized hospital, 16013, Algiers, Algeria.
*Corresponding Author: Abdelkader Boukhmis, Department of cardiovascular surgery of Mohamed Abderrahmani specialized hospital, 16013, Algiers, Algeria.
Citation: M. S. Opanasenko, B. M. Konik, O. V. Tereshkovich, Ya. S. Stavytska, A. M. Stepaniuk, et al, (2026), Gender Disparities in Coronary Artery Bypass Grafting Outcomes: a Single-Centre Prospective Study, J Thoracic Disease and Cardiothoracic Surgery, 7(1); DOI:10.31579/2693-2156/158
Copyright: © 2026, Abdelkader Boukhmis. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Received: 09 January 2026 | Accepted: 19 January 2026 | Published: 02 February 2026
Keywords:
Objectives: Recent publications highlighted higher operative mortality in women compared to men following isolated coronary artery bypass grafting. Our objective was to evaluate the sex differences of this procedure in our country.
Methods: This prospective, observational, comparative, single-centre study included 260 consecutive patients who underwent isolated coronary artery bypass grafting, of whom 18.84% were women. Women were older than men (61.8 VS 58.7 years, p=0.04), had more arterial hypertension (85.7% VS 62.1%, p=0.001), and more preoperative strokes (8.2% VS 4.3%, p=0.04). All coronary artery bypass grafting procedures were on pump, and bilateral internal thoracic artery grafting was avoided in obese and diabetic women, as well as in patients over 70 years of age. The gender comparison was based on surgical techniques and operative mortality and morbidity.
Results: Although women benefited from the same rate of complete myocardial revascularization (Women: 77.5% vs. Men: 75.8%, p=0.85), they received fewer multiple arterial coronary grafting (Women: 36.7% VS Men: 60.2%, p=0.003) and total arterial coronary grafting (Women: 28.5% VS Men: 48.8%, p=0.01). Operative mortality tended to be higher in women (Women :6.12% VS Men: 2.37%, OR: 2.67, 95% CI: 0.40-14.30, p=0.17), while operative morbidity was similar to that of men: stroke (Women: 0% vs. Men: 2.8%, p=0.59), myocardial infarction (Women: 6.1% vs. Men: 5.7%, p=1) and deep sternal wounds infections (Women: 2.04% VS Men: 0.94, p=0.45).
Conclusion: Algerian women undergoing isolated coronary artery bypass grafting have more co-morbidities, are less likely to benefit from multiple and total arterial grafting and tend to have higher operative mortality rate than men.
ANOVA: analysis of variance test
BITA: bilateral internal thoracic artery.
BMI: body mass index.
CABG: coronary artery bypass grafting.
CAD: coronary artery disease.
CI: confidence interval.
DSWI: deep sternal wound infections.
Euro SCORE II: european System for Cardiac Operative Risk Evaluation II.
ITA: internal thoracic arteries.
LVEF: left ventricular ejection fraction M: men.
MACCE: major cardiac and cerebrovascular events.
MI: myocardial infarction.
OR: odds ratio.
SPSS: statistical Package for the Social Sciences.
W: women
Currently, data enabling appropriate guidance on coronary artery bypass grafting (CABG) in women are limited, and the earliest studies that greatly influenced international guidelines were conducted exclusively in men [1, 2]. Thus, current evidence regarding coronary artery disease (CAD) in women is no more than an extrapolation from that in men.
Recently published studies report on the epidemiological [3], pathological [4, 5], and clinical specificities of ischaemic heart disease in women. American registries [7] and recent meta-analyses [8] highlight the more severe comorbidities of women who are considered for CABG, their low likelihood of access to multiple and total arterial bypass techniques [6], and their higher operative and late morbidity and mortality rates.
In light of these publications, we conducted this study to elucidate gender disparities in CABG outcomes in our country.
This is a prospective, observational, comparative and a single-centre study conducted in a cardiac surgery department in Algiers.
After obtaining approval from the expert committee of the Faculty of Medicine in Algiers, we prospectively collected data on 260 consecutive patients, 18.84% (n=49) of whom were women, who were referred for isolated CABG. Data collection was prospectively performed using patient records.
The gender comparison criteria were: cardiovascular risk factors, preoperative comorbidities, surgical techniques, operative mortality and morbidity: stroke, myocardial infarction (MI), and deep sternal wound infections (DSWI).
All interventions carried out in this study involving human participants were in accordance with the ethical standards of the Faculty of Medicine of Algiers and those of the Helsinki Declaration (1964, amended most recently in 2008) of the World Medical Association. Informed consent for an isolated CABG was obtained from all participants.
We included all consecutive patients aged between 18 and 85 who underwent isolated CABG. Exclusion criteria: combination with another cardiac surgical procedure, particularly valve surgery. Redo CABG or CABG performed as an emergency procedure.
Isolated CABG was performed via median sternotomy with a normothermic cardiopulmonary bypass. Cardioplegic arrest was achieved using cold blood cardioplegia. Bilateral internal thoracic artery (BITA) grafting was avoided in obese and diabetic women, as well as in patients over 70 years of age and those suffering from chronic lung disease. Internal thoracic arteries (ITAs) were harvested in a skeletonised fashion, and proximal anastomoses to the ascending aorta were performed under total aortic cross-clamping.
Statistical analyses were performed using Statistical Package for the Social Sciences (SPSS) version 19.0 software (SPSS Inc., Chicago, Illinois). Baseline characteristics were presented as median and standard deviations for continuous variables and count (percent) for categoric variables. The counts and frequencies were compared using the chi-square test, Fisher's exact test, and their odds ratios with a 95% confidence interval. The averages were compared using the analysis of variance test (ANOVA). The p-value is considered statistically significant if it is less than 0.05.
Women (W) were older than men (M) (W: 61.8 +/-10 years VS M: 58.7+/-9.6 years, 95% CI -6.1215-0.0785, p=0.04), with a sex ratio ranging from 1W /10.5M in patients under 45 years of age to 1W /1.1M in those over 75 years of age (Figure 1).
Figure 1: Evolution of the sex ratio according to patient age
The proportion of patients presenting with diabetes mellitus and dyslipidemia was not statistically different between the two genders (Table 1).
| Women | Men | ||
| Âge (year) | 61.8 +/- 10 | 58.7+/-9.6 | 95% CI [6.121-0.078], p= 0.04 |
| Hypertension | 85.7% (42/49) | 62.1% (131/211) | OR : 3.648, 95% CI [1.526-10.096], p=0.001 |
| Hyperlipidemia | 61.2% (30/49) | 56.4% (119/211) | OR : 1.219, 95% CI [0.619-2.449], p=0.63 |
| Obesity (BMI≥30Kg/m²) | 39% (19/49) | 25% (53/211) | OR :1.931, 95% CI [0.943-3.892], p=0.07 |
| Diabètes mellitus | 69.4% (34/49) | 58.3% (123/211) | OR : 1.619, 95% CI [0.801-3.403], p=0.194 |
| Current smoking | 10.2% (5/49) | 59.2% (125/211) | OR : 12.79, 95% CI [4.87-33.57], p< 0> |
Table 1: Sex differences in cardiovascular risk factors.
BMI: Body mass index, CI: confidence interval, OR: Odds ratio, p= p-value.
While women were more frequently affected by high blood pressure (OR: 3.65, 95% CI: 1.53-10.09, p=0.001) and had a strong tendency to be obese (BMI ≥30 kg/m²) (OR: 1.93, 95% CI: 0.94-3.89, p=0.07), the proportion of active smokers was significantly higher among men (Table 1).
Women had a strong tendency to present more atrial fibrillation (OR: 3.29, 95% CI: 0.78-12.69, p=0.053), had more strokes (OR: 3.95, 95% CI: 0.85-14.88, p=0.04), and a lower creatinine clearance than men (p=0.02). Conversely, men had a strong tendency to have more previous
hospitalizations for acute coronary syndrome (OR: 1.8, 95% CI: 0.94-3.45, p=0.081) and had more impaired left ventricular ejection fraction (LVEF˂50%) than women (OR: 2.44, 95% CI: 1.08-5.49; p=0.035) (Table 2).
On the other hand, there were no statistically significant differences between the two sexes in terms of the occurrence of Left main coronary artery diseases (p=0.16) or triple vessel disease (p=0.63) (Table 2) or in the operative mortality risk estimated by the European System for Cardiac Operative Risk Evaluation II (EuroSCORE II): Women: 1.70+/-1.26% VS Men: 1.48/-1.38%, 95% CI: -0.64-0.20, p=0.3. (Table 2).
| Comorbidities | Women | Men | ||
| ACS History | 61.3% (30/49) | 73.9% (156/211) | OR : 0.558, 95% CI [0.278-1.139], p=0.08 | |
| Atrial fibrillation | 10.2 % (5/49) | 3.3 % (7/211) | OR : 3.291, 95% CI [0.786-12.699], p= 0.053 | |
| Extracardiac arteriopathy | 20.4% (10/49) | 23.7% (50/211) | OR : 0.826, 95% CI [0.343-1.84], p= 0.70 | |
| Stroke | 8.16 % (4/49) | 4.26% (9/211) | OR : 3.952, 95% CI [0.854-14.878], p=0.039 | |
| chronic lung disease | 4.08% (2/49) | 5.7% (12/211) | OR : 0.706, 95% CI [0.074-3.339], p=1 | |
| CrCl ml/min | 84.8+/-29.8 | 95.1+/- 29 | 95% CI (1.197-19.403), p=0.02 | |
| LVEF | 57.9 +/-12.7 % | 54.5+/-12.38% | 95% CI (-7.285-0.485), p = 0.086 | |
| LVEF˂50% | 16.3% (8/49) | 32.2% (68/211) | OR : 0.412, 95% CI [0.158-0.953] ; p=0.03 | |
| LMCA diseases | 12.2% (6/49) | 21.8% (46/211) | OR : 0.502, 95% CI [0.164-1.286], p=0.16 | |
| Triple vessel diseases | 59.2% (29/49) | 54.5% (115/211) | OR : 1.209, 95% CI [0.617-2.41], p=0.63 | |
| EuroSCORE II | 1.70+/-1.26 | 1.48+/-1.38 | 95% CI (-0.644-0.204), p= 0.308 | |
Table 2: Sex differences in preoperative comorbidities
ACS: Acute coronary syndrome, CI: confidence interval, CrCl: Creatinine clearance, EuroSCORE II: European System for Cardiac Operative Risk Evaluation II, LMCA: Left main coronary artery diseases, LVEF: Left ventricle ejection fraction, OR: Odds ratio, p= p-value.
Although women benefited from the same rate of complete myocardial revascularization (W: 77.5% VS M: 75.8%, p=0.85), and the same rate of distal coronary anastomoses per patient (W: 2.24+/-0.9 VS M: 2.34+/-0.84, p=0.45) than men, they benefited from fewer multiple -arterial coronary grafting (W: 36.7% VS M: 60.2%, OR: 0.38, 95% CI: 0.19-0.76, p=0.003) and total-arterial bypass grafting (W: 28.5% VS M: 48.8%, OR: 0.42, 95% CI: 0.12-0.86, p=0.01) (Table 3).
| Women | Men | ||
| Number of distal anastomoses/patients | 2.24+/-0.90 | 2.34/-0.84 | 95% CI [0.166-0.366], p = 0.45 |
| Complète Revascularization | 77.5% (38/49) | 75.8% (160/211) | OR : 1.101, 95% CI [0.505-2.567], p= 0.85 |
| MAG | 36.7% (18/49) | 60.2% (127/211) | OR : 0.385, 95% CI [0.19-0.763], p=0.003 |
| TAG | 28.5% (14/49) | 48.8% (103/211) | OR : 0.421, 95% CI [0.197-0.857], p=0.01 |
Table 3: Sex differences in coronary artery bypass grafting techniques.
BMI: Body mass index, CI: confidence interval, MAG: Multiple arterial grafting, OR: Odds ratio, p= p-value. TAG: Total arterial grafting.
Although operative mortality was not statistically different between the two sexes, it tended to be higher in women (W: 6.12% VS M: 2.37%, OR: 2.67, 95% CI: 0.40-14.30, p = 0.17) and seems to be driven by a tendency to develop more postoperative low cardiac output (OR: 2.246, IC à 95% [0.474-8.835], p=0.24) (Table 3).
| Operative mortality and morbidity | Women | Men | |
| Operative mortality | 6.12% (3/49) | 2.37% (5/211) | OR : 2.6739, 95% CI [0.4011 ; 14.309], p=0.17 |
| LCO | 8.16% (4/49) | 3.79% (8/211) | OR : 2.247, 95% CI [0.474 ; 8.835], p=0.24 |
| Stroke | 0% (0/49) | 2.8 % (6/211) | P=0.35 |
| MI | 6.1% (3/49) | 5.7% (12/211) | OR : 1.081, 95% CI [0.188- 4.235], P=1 |
| DSWI | 2.04% (1/49) | 0.94% (2/211) | OR : 2.2521, 95% CI [0.037-44.198], p=0.45 |
Table 4: Gender disparities in mortality and morbidity associated with isolated CABG
CI: confidence interval, DSWI: Deep sternal wound infection, LCO: Low Cardiac output, MI: Myocardial infarction, OR: Odds ratio, p= p-value
There was parity between the sexes concerning stroke (W: 0% VS M: 2.8%, p=0.59), MI (W: 6.1% VS M: 5.7%, OR: 1.08, 95% CI: 0.19-4.23, p=1) and DSWI rate (W: 2.04% VS M: 0.94%, OR: 2.2521, 95% CI: 0.037-44.198, p=0.45).
The main conclusions of this prospective study are as follows:
Underestimated for a long time, cardiovascular disease is currently the number one killer of women in the United States, where it accounts for a third of all female deaths, surpassing the mortality rate caused by all female cancers combined. Between 1984 and 2012, more women died from cardiovascular disease than men [3].
In addition to the classic cardiovascular risk factors common to both sexes, women are also subject to specific cardiovascular risk factors, such as: preterm delivery, gestational hypertension, gestational diabetes, autoimmune diseases, breast cancer treatments (radiotherapy and chemotherapy), and depression [4, 5]. Furthermore, the influence of various risk factors differs between the two sexes. The harmful impact of smoking is more pronounced in women than in men. Moreover, menopause has a significant effect on women, as there is a higher incidence of plaque rupture in older women [9]. The multiplicity of these cardiovascular risk factors, to which women are exposed from a young age, gives their coronary artery disease a particular anatomical and pathological feature. Indeed, coronary lesions in young women tend to be diffuse and non-obstructive. Smilowitz et al [10] has observed that myocardial infarctions secondary to non-obstructive coronary lesions are more common in women. With age, coronary lesions in women become increasingly obstructive, gradually resembling those in men. Women often present with coronary microcirculation dysfunction, endothelial dysfunction, limited coronary flow reserves, spontaneous coronary artery dissections, more frequent intramyocardial coronary arteries, and stress-induced cardiomyopathies (Takotsubo) [4, 5, 9].
Several studies have highlighted the particularity of coronary artery disease symptoms in women, as well as their lower chances of receiving the same standard of treatment as men [11-13]. In fact, women become symptomatic on average 10 years later than men, and their symptoms are often atypical, sometimes leading to misdiagnosis. They suffer from more comorbidities and develop more silent myocardial infarctions and sudden deaths. They often present with more invalidating symptoms despite angiographically insignificant lesions, indicating involvement of their microcirculation. In addition, they are less likely than men to receive optimal medical treatment. These diagnostic delays and disparities in preoperative care explain the poorer clinical profile of women candidates for CABG and inevitably lead to different surgical outcomes compared to men.
A recent study of the American registry [14], including 2.5 million patients, 28% of whom were women, noted that after isolated CABG, women were associated with a persistent increase, over a 12-year period, in the adjusted risk of all-cause mortality (OR: 1.43), stroke (OR: 1.34) and thoracic complications (OR: 1.28). This finding was also mentioned in a recent meta-analysis [8], which showed that women were associated with a higher risk of operative and late mortality as well as post-operative MI and stroke than men. Furthermore, a systematic review of four randomised studies (ART, CORONARY, GOPCABE, PREVENT IV) [15] noted that although 5-year mortality was equal between the two sexes, the rate of major cardiac and cerebrovascular events (MACCE) was higher in women, driven by a higher rate of MI at 30 days and, consequently, a higher rate of repeat revascularization. It has also been mentioned that the difference between the two sexes in terms of in-hospital mortality and MACCE five years after an isolated CABG is inversely correlated with age. These differences are greatest in young subjects and tend to disappear after the age of 75 [15, 16]. This levelling out with age of gender differences in CABG morbidity and mortality can be explained by the fact that coronary lesions in women become more obstructive with age, thus resembling those in men more closely; furthermore, the spasticity of coronary arteries and arterial grafts in women decreases with age, thereby reducing the incidence of MI; and finally, comorbidities in men increase with age, thus matching those in women.
In our study, women were less likely to receive multiple-arterial or total-arterial coronary bypass surgery. There are two explanations for that: (a) on the one hand, the combination of diabetes and obesity, which was more common among our female patients, would have exposed them to a much higher risk than men of developing DSWI after BITA grafting [17], (b) on the other hand, in our cohort, the proportion of women over the age of 70 is higher than that of men, and after this age, it has been established that BITA grafting loses its long-term survival benefit compared to the single internal thoracic artery grafting [18]. This finding was recently noted in the Society of Thoracic Surgeons database, which included more than 1.2 million patients who had undergone CABG between 2011 and 2019, confirming that women were significantly less likely to receive complete revascularization, a left ITA-left anterior descending artery grafting, a radial artery as a second graft, or BITA grafting [19].
This inequality in access to optimal CABG surgical techniques is particularly disadvantageous for women, as a recent observational study [20] and a meta-analysis of six randomised studies [21] have clearly demonstrated that the very long-term survival of women is improved, as much as that of men, by BITA grafting, by multiple-arterial bypass grafting, and by complete revascularization.
Furthermore, several authors have reported on the technical complexity of CABG in women. It has been established that the diameter of the major epicardial coronary arteries is smaller in women, even after adjusting for body surface and for left ventricular mass [22]. This may explain the higher proportion of incomplete revascularization in women. In addition, it has been shown that the diameters and flow rates of women's radial arteries are also smaller than those of men, even after adjusting for body mass index [23]. This may explain why it is more difficult to use arterial grafts in women, particularly when performing sequential anastomoses and composite arterial grafts. Furthermore, it has also been shown that arterial grafts from women are more spasmodic and more reactive to vasoconstrictors (ITAs-serotonin and radial arteries-noradrenaline) than those from men [24, 25]. This increased spasmodicity contributes to postoperative spasms in these arterial grafts, which can cause postoperative ischemia or even myocardial infarction, more frequently observed in women.
Based on these studies, the poorer outcomes of isolated CABG in women compared to men can be attributed to:
Limitations of this study are (a) its single-centre nature and (b) its small sample size. A multicentric study conducted over a longer period and involving a larger cohort would yield more statistically robust results.
Algerian women undergoing isolated coronary artery bypass grafting are older, have more comorbidities, have less likelihood of benefiting from multiple or total-arterial bypass grafting, and tend to have higher operative mortality than men.
Disclosure of Funding:
This research did not receive any specific funding from public, commercial or non-profit funding organisations.
Disclosure of any Conflict of interest: None to declare.
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Dear editorial department: On behalf of our team, I hereby certify the reliability and superiority of the International Journal of Clinical Case Reports and Reviews in the peer review process, editorial support, and journal quality. Firstly, the peer review process of the International Journal of Clinical Case Reports and Reviews is rigorous, fair, transparent, fast, and of high quality. The editorial department invites experts from relevant fields as anonymous reviewers to review all submitted manuscripts. These experts have rich academic backgrounds and experience, and can accurately evaluate the academic quality, originality, and suitability of manuscripts. The editorial department is committed to ensuring the rigor of the peer review process, while also making every effort to ensure a fast review cycle to meet the needs of authors and the academic community. Secondly, the editorial team of the International Journal of Clinical Case Reports and Reviews is composed of a group of senior scholars and professionals with rich experience and professional knowledge in related fields. The editorial department is committed to assisting authors in improving their manuscripts, ensuring their academic accuracy, clarity, and completeness. Editors actively collaborate with authors, providing useful suggestions and feedback to promote the improvement and development of the manuscript. We believe that the support of the editorial department is one of the key factors in ensuring the quality of the journal. Finally, the International Journal of Clinical Case Reports and Reviews is renowned for its high- quality articles and strict academic standards. The editorial department is committed to publishing innovative and academically valuable research results to promote the development and progress of related fields. The International Journal of Clinical Case Reports and Reviews is reasonably priced and ensures excellent service and quality ratio, allowing authors to obtain high-level academic publishing opportunities in an affordable manner. I hereby solemnly declare that the International Journal of Clinical Case Reports and Reviews has a high level of credibility and superiority in terms of peer review process, editorial support, reasonable fees, and journal quality. Sincerely, Rui Tao.
Clinical Cardiology and Cardiovascular Interventions I testity the covering of the peer review process, support from the editorial office, and quality of the journal.
Clinical Cardiology and Cardiovascular Interventions, we deeply appreciate the interest shown in our work and its publication. It has been a true pleasure to collaborate with you. The peer review process, as well as the support provided by the editorial office, have been exceptional, and the quality of the journal is very high, which was a determining factor in our decision to publish with you.
The peer reviewers process is quick and effective, the supports from editorial office is excellent, the quality of journal is high. I would like to collabroate with Internatioanl journal of Clinical Case Reports and Reviews journal clinically in the future time.
Clinical Cardiology and Cardiovascular Interventions, I would like to express my sincerest gratitude for the trust placed in our team for the publication in your journal. It has been a true pleasure to collaborate with you on this project. I am pleased to inform you that both the peer review process and the attention from the editorial coordination have been excellent. Your team has worked with dedication and professionalism to ensure that your publication meets the highest standards of quality. We are confident that this collaboration will result in mutual success, and we are eager to see the fruits of this shared effort.
Dear Dr. Jessica Magne, Editorial Coordinator 0f Clinical Cardiology and Cardiovascular Interventions, I hope this message finds you well. I want to express my utmost gratitude for your excellent work and for the dedication and speed in the publication process of my article titled "Navigating Innovation: Qualitative Insights on Using Technology for Health Education in Acute Coronary Syndrome Patients." I am very satisfied with the peer review process, the support from the editorial office, and the quality of the journal. I hope we can maintain our scientific relationship in the long term.
Dear Monica Gissare, - Editorial Coordinator of Nutrition and Food Processing. ¨My testimony with you is truly professional, with a positive response regarding the follow-up of the article and its review, you took into account my qualities and the importance of the topic¨.
Dear Dr. Jessica Magne, Editorial Coordinator 0f Clinical Cardiology and Cardiovascular Interventions, The review process for the article “The Handling of Anti-aggregants and Anticoagulants in the Oncologic Heart Patient Submitted to Surgery” was extremely rigorous and detailed. From the initial submission to the final acceptance, the editorial team at the “Journal of Clinical Cardiology and Cardiovascular Interventions” demonstrated a high level of professionalism and dedication. The reviewers provided constructive and detailed feedback, which was essential for improving the quality of our work. Communication was always clear and efficient, ensuring that all our questions were promptly addressed. The quality of the “Journal of Clinical Cardiology and Cardiovascular Interventions” is undeniable. It is a peer-reviewed, open-access publication dedicated exclusively to disseminating high-quality research in the field of clinical cardiology and cardiovascular interventions. The journal's impact factor is currently under evaluation, and it is indexed in reputable databases, which further reinforces its credibility and relevance in the scientific field. I highly recommend this journal to researchers looking for a reputable platform to publish their studies.
Dear Editorial Coordinator of the Journal of Nutrition and Food Processing! "I would like to thank the Journal of Nutrition and Food Processing for including and publishing my article. The peer review process was very quick, movement and precise. The Editorial Board has done an extremely conscientious job with much help, valuable comments and advices. I find the journal very valuable from a professional point of view, thank you very much for allowing me to be part of it and I would like to participate in the future!”
Dealing with The Journal of Neurology and Neurological Surgery was very smooth and comprehensive. The office staff took time to address my needs and the response from editors and the office was prompt and fair. I certainly hope to publish with this journal again.Their professionalism is apparent and more than satisfactory. Susan Weiner
My Testimonial Covering as fellowing: Lin-Show Chin. The peer reviewers process is quick and effective, the supports from editorial office is excellent, the quality of journal is high. I would like to collabroate with Internatioanl journal of Clinical Case Reports and Reviews.
My experience publishing in Psychology and Mental Health Care was exceptional. The peer review process was rigorous and constructive, with reviewers providing valuable insights that helped enhance the quality of our work. The editorial team was highly supportive and responsive, making the submission process smooth and efficient. The journal's commitment to high standards and academic rigor makes it a respected platform for quality research. I am grateful for the opportunity to publish in such a reputable journal.
My experience publishing in International Journal of Clinical Case Reports and Reviews was exceptional. I Come forth to Provide a Testimonial Covering the Peer Review Process and the editorial office for the Professional and Impartial Evaluation of the Manuscript.
I would like to offer my testimony in the support. I have received through the peer review process and support the editorial office where they are to support young authors like me, encourage them to publish their work in your esteemed journals, and globalize and share knowledge globally. I really appreciate your journal, peer review, and editorial office.
Dear Agrippa Hilda- Editorial Coordinator of Journal of Neuroscience and Neurological Surgery, "The peer review process was very quick and of high quality, which can also be seen in the articles in the journal. The collaboration with the editorial office was very good."
I would like to express my sincere gratitude for the support and efficiency provided by the editorial office throughout the publication process of my article, “Delayed Vulvar Metastases from Rectal Carcinoma: A Case Report.” I greatly appreciate the assistance and guidance I received from your team, which made the entire process smooth and efficient. The peer review process was thorough and constructive, contributing to the overall quality of the final article. I am very grateful for the high level of professionalism and commitment shown by the editorial staff, and I look forward to maintaining a long-term collaboration with the International Journal of Clinical Case Reports and Reviews.
To Dear Erin Aust, I would like to express my heartfelt appreciation for the opportunity to have my work published in this esteemed journal. The entire publication process was smooth and well-organized, and I am extremely satisfied with the final result. The Editorial Team demonstrated the utmost professionalism, providing prompt and insightful feedback throughout the review process. Their clear communication and constructive suggestions were invaluable in enhancing my manuscript, and their meticulous attention to detail and dedication to quality are truly commendable. Additionally, the support from the Editorial Office was exceptional. From the initial submission to the final publication, I was guided through every step of the process with great care and professionalism. The team's responsiveness and assistance made the entire experience both easy and stress-free. I am also deeply impressed by the quality and reputation of the journal. It is an honor to have my research featured in such a respected publication, and I am confident that it will make a meaningful contribution to the field.
"I am grateful for the opportunity of contributing to [International Journal of Clinical Case Reports and Reviews] and for the rigorous review process that enhances the quality of research published in your esteemed journal. I sincerely appreciate the time and effort of your team who have dedicatedly helped me in improvising changes and modifying my manuscript. The insightful comments and constructive feedback provided have been invaluable in refining and strengthening my work".
I thank the ‘Journal of Clinical Research and Reports’ for accepting this article for publication. This is a rigorously peer reviewed journal which is on all major global scientific data bases. I note the review process was prompt, thorough and professionally critical. It gave us an insight into a number of important scientific/statistical issues. The review prompted us to review the relevant literature again and look at the limitations of the study. The peer reviewers were open, clear in the instructions and the editorial team was very prompt in their communication. This journal certainly publishes quality research articles. I would recommend the journal for any future publications.
Dear Jessica Magne, with gratitude for the joint work. Fast process of receiving and processing the submitted scientific materials in “Clinical Cardiology and Cardiovascular Interventions”. High level of competence of the editors with clear and correct recommendations and ideas for enriching the article.
We found the peer review process quick and positive in its input. The support from the editorial officer has been very agile, always with the intention of improving the article and taking into account our subsequent corrections.
My article, titled 'No Way Out of the Smartphone Epidemic Without Considering the Insights of Brain Research,' has been republished in the International Journal of Clinical Case Reports and Reviews. The review process was seamless and professional, with the editors being both friendly and supportive. I am deeply grateful for their efforts.
To Dear Erin Aust – Editorial Coordinator of Journal of General Medicine and Clinical Practice! I declare that I am absolutely satisfied with your work carried out with great competence in following the manuscript during the various stages from its receipt, during the revision process to the final acceptance for publication. Thank Prof. Elvira Farina
Dear Jessica, and the super professional team of the ‘Clinical Cardiology and Cardiovascular Interventions’ I am sincerely grateful to the coordinated work of the journal team for the no problem with the submission of my manuscript: “Cardiometabolic Disorders in A Pregnant Woman with Severe Preeclampsia on the Background of Morbid Obesity (Case Report).” The review process by 5 experts was fast, and the comments were professional, which made it more specific and academic, and the process of publication and presentation of the article was excellent. I recommend that my colleagues publish articles in this journal, and I am interested in further scientific cooperation. Sincerely and best wishes, Dr. Oleg Golyanovskiy.
Dear Ashley Rosa, Editorial Coordinator of the journal - Psychology and Mental Health Care. " The process of obtaining publication of my article in the Psychology and Mental Health Journal was positive in all areas. The peer review process resulted in a number of valuable comments, the editorial process was collaborative and timely, and the quality of this journal has been quickly noticed, resulting in alternative journals contacting me to publish with them." Warm regards, Susan Anne Smith, PhD. Australian Breastfeeding Association.
Dear Jessica Magne, Editorial Coordinator, Clinical Cardiology and Cardiovascular Interventions, Auctores Publishing LLC. I appreciate the journal (JCCI) editorial office support, the entire team leads were always ready to help, not only on technical front but also on thorough process. Also, I should thank dear reviewers’ attention to detail and creative approach to teach me and bring new insights by their comments. Surely, more discussions and introduction of other hemodynamic devices would provide better prevention and management of shock states. Your efforts and dedication in presenting educational materials in this journal are commendable. Best wishes from, Farahnaz Fallahian.
Dear Maria Emerson, Editorial Coordinator, International Journal of Clinical Case Reports and Reviews, Auctores Publishing LLC. I am delighted to have published our manuscript, "Acute Colonic Pseudo-Obstruction (ACPO): A rare but serious complication following caesarean section." I want to thank the editorial team, especially Maria Emerson, for their prompt review of the manuscript, quick responses to queries, and overall support. Yours sincerely Dr. Victor Olagundoye.
Dear Ashley Rosa, Editorial Coordinator, International Journal of Clinical Case Reports and Reviews. Many thanks for publishing this manuscript after I lost confidence the editors were most helpful, more than other journals Best wishes from, Susan Anne Smith, PhD. Australian Breastfeeding Association.
Dear Agrippa Hilda, Editorial Coordinator, Journal of Neuroscience and Neurological Surgery. The entire process including article submission, review, revision, and publication was extremely easy. The journal editor was prompt and helpful, and the reviewers contributed to the quality of the paper. Thank you so much! Eric Nussbaum, MD
Dr Hala Al Shaikh This is to acknowledge that the peer review process for the article ’ A Novel Gnrh1 Gene Mutation in Four Omani Male Siblings, Presentation and Management ’ sent to the International Journal of Clinical Case Reports and Reviews was quick and smooth. The editorial office was prompt with easy communication.
Dear Erin Aust, Editorial Coordinator, Journal of General Medicine and Clinical Practice. We are pleased to share our experience with the “Journal of General Medicine and Clinical Practice”, following the successful publication of our article. The peer review process was thorough and constructive, helping to improve the clarity and quality of the manuscript. We are especially thankful to Ms. Erin Aust, the Editorial Coordinator, for her prompt communication and continuous support throughout the process. Her professionalism ensured a smooth and efficient publication experience. The journal upholds high editorial standards, and we highly recommend it to fellow researchers seeking a credible platform for their work. Best wishes By, Dr. Rakhi Mishra.
Dear Jessica Magne, Editorial Coordinator, Clinical Cardiology and Cardiovascular Interventions, Auctores Publishing LLC. The peer review process of the journal of Clinical Cardiology and Cardiovascular Interventions was excellent and fast, as was the support of the editorial office and the quality of the journal. Kind regards Walter F. Riesen Prof. Dr. Dr. h.c. Walter F. Riesen.
Dear Ashley Rosa, Editorial Coordinator, International Journal of Clinical Case Reports and Reviews, Auctores Publishing LLC. Thank you for publishing our article, Exploring Clozapine's Efficacy in Managing Aggression: A Multiple Single-Case Study in Forensic Psychiatry in the international journal of clinical case reports and reviews. We found the peer review process very professional and efficient. The comments were constructive, and the whole process was efficient. On behalf of the co-authors, I would like to thank you for publishing this article. With regards, Dr. Jelle R. Lettinga.
Dear Clarissa Eric, Editorial Coordinator, Journal of Clinical Case Reports and Studies, I would like to express my deep admiration for the exceptional professionalism demonstrated by your journal. I am thoroughly impressed by the speed of the editorial process, the substantive and insightful reviews, and the meticulous preparation of the manuscript for publication. Additionally, I greatly appreciate the courteous and immediate responses from your editorial office to all my inquiries. Best Regards, Dariusz Ziora
Dear Chrystine Mejia, Editorial Coordinator, Journal of Neurodegeneration and Neurorehabilitation, Auctores Publishing LLC, We would like to thank the editorial team for the smooth and high-quality communication leading up to the publication of our article in the Journal of Neurodegeneration and Neurorehabilitation. The reviewers have extensive knowledge in the field, and their relevant questions helped to add value to our publication. Kind regards, Dr. Ravi Shrivastava.
Dear Clarissa Eric, Editorial Coordinator, Journal of Clinical Case Reports and Studies, Auctores Publishing LLC, USA Office: +1-(302)-520-2644. I would like to express my sincere appreciation for the efficient and professional handling of my case report by the ‘Journal of Clinical Case Reports and Studies’. The peer review process was not only fast but also highly constructive—the reviewers’ comments were clear, relevant, and greatly helped me improve the quality and clarity of my manuscript. I also received excellent support from the editorial office throughout the process. Communication was smooth and timely, and I felt well guided at every stage, from submission to publication. The overall quality and rigor of the journal are truly commendable. I am pleased to have published my work with Journal of Clinical Case Reports and Studies, and I look forward to future opportunities for collaboration. Sincerely, Aline Tollet, UCLouvain.
Dear Ms. Mayra Duenas, Editorial Coordinator, International Journal of Clinical Case Reports and Reviews. “The International Journal of Clinical Case Reports and Reviews represented the “ideal house” to share with the research community a first experience with the use of the Simeox device for speech rehabilitation. High scientific reputation and attractive website communication were first determinants for the selection of this Journal, and the following submission process exceeded expectations: fast but highly professional peer review, great support by the editorial office, elegant graphic layout. Exactly what a dynamic research team - also composed by allied professionals - needs!" From, Chiara Beccaluva, PT - Italy.
Dear Maria Emerson, Editorial Coordinator, we have deeply appreciated the professionalism demonstrated by the International Journal of Clinical Case Reports and Reviews. The reviewers have extensive knowledge of our field and have been very efficient and fast in supporting the process. I am really looking forward to further collaboration. Thanks. Best regards, Dr. Claudio Ligresti
Dear Chrystine Mejia, Editorial Coordinator, Journal of Neurodegeneration and Neurorehabilitation. “The peer review process was efficient and constructive, and the editorial office provided excellent communication and support throughout. The journal ensures scientific rigor and high editorial standards, while also offering a smooth and timely publication process. We sincerely appreciate the work of the editorial team in facilitating the dissemination of innovative approaches such as the Bonori Method.” Best regards, Dr. Matteo Bonori.
I recommend without hesitation submitting relevant papers on medical decision making to the International Journal of Clinical Case Reports and Reviews. I am very grateful to the editorial staff. Maria Emerson was a pleasure to communicate with. The time from submission to publication was an extremely short 3 weeks. The editorial staff submitted the paper to three reviewers. Two of the reviewers commented positively on the value of publishing the paper. The editorial staff quickly recognized the third reviewer’s comments as an unjust attempt to reject the paper. I revised the paper as recommended by the first two reviewers.
Dear Maria Emerson, Editorial Coordinator, Journal of Clinical Research and Reports. Thank you for publishing our case report: "Clinical Case of Effective Fetal Stem Cells Treatment in a Patient with Autism Spectrum Disorder" within the "Journal of Clinical Research and Reports" being submitted by the team of EmCell doctors from Kyiv, Ukraine. We much appreciate a professional and transparent peer-review process from Auctores. All research Doctors are so grateful to your Editorial Office and Auctores Publishing support! I amiably wish our article publication maintained a top quality of your International Scientific Journal. My best wishes for a prosperity of the Journal of Clinical Research and Reports. Hope our scientific relationship and cooperation will remain long lasting. Thank you very much indeed. Kind regards, Dr. Andriy Sinelnyk Cell Therapy Center EmCell
Dear Editorial Team, Clinical Cardiology and Cardiovascular Interventions. It was truly a rewarding experience to work with the journal “Clinical Cardiology and Cardiovascular Interventions”. The peer review process was insightful and encouraging, helping us refine our work to a higher standard. The editorial office offered exceptional support with prompt and thoughtful communication. I highly value the journal’s role in promoting scientific advancement and am honored to be part of it. Best regards, Meng-Jou Lee, MD, Department of Anesthesiology, National Taiwan University Hospital.
Dear Editorial Team, Journal-Clinical Cardiology and Cardiovascular Interventions, “Publishing my article with Clinical Cardiology and Cardiovascular Interventions has been a highly positive experience. The peer-review process was rigorous yet supportive, offering valuable feedback that strengthened my work. The editorial team demonstrated exceptional professionalism, prompt communication, and a genuine commitment to maintaining the highest scientific standards. I am very pleased with the publication quality and proud to be associated with such a reputable journal.” Warm regards, Dr. Mahmoud Kamal Moustafa Ahmed
Dear Maria Emerson, Editorial Coordinator of ‘International Journal of Clinical Case Reports and Reviews’, I appreciate the opportunity to publish my article with your journal. The editorial office provided clear communication during the submission and review process, and I found the overall experience professional and constructive. Best regards, Elena Salvatore.
Dear Mayra Duenas, Editorial Coordinator of ‘International Journal of Clinical Case Reports and Reviews Herewith I confirm an optimal peer review process and a great support of the editorial office of the present journal
Dear Editorial Team, Clinical Cardiology and Cardiovascular Interventions. I am really grateful for the peers review; their feedback gave me the opportunity to reflect on the message and impact of my work and to ameliorate the article. The editors did a great job in addition by encouraging me to continue with the process of publishing.
Dear Cecilia Lilly, Editorial Coordinator, Endocrinology and Disorders, Thank you so much for your quick response regarding reviewing and all process till publishing our manuscript entitled: Prevalence of Pre-Diabetes and its Associated Risk Factors Among Nile College Students, Sudan. Best regards, Dr Mamoun Magzoub.
International Journal of Clinical Case Reports and Reviews is a high quality journal that has a clear and concise submission process. The peer review process was comprehensive and constructive. Support from the editorial office was excellent, since the administrative staff were responsive. The journal provides a fast and timely publication timeline.
Dear Maria Emerson, Editorial Coordinator of International Journal of Clinical Case Reports and Reviews, What distinguishes International Journal of Clinical Case Report and Review is not only the scientific rigor of its publications, but the intellectual climate in which research is evaluated. The submission process is refreshingly free of unnecessary formal barriers and bureaucratic rituals that often complicate academic publishing without adding real value. The peer-review system is demanding yet constructive, guided by genuine scientific dialogue rather than hierarchical or authoritarian attitudes. Reviewers act as collaborators in improving the manuscript, not as gatekeepers imposing arbitrary standards. This journal offers a rare balance: high methodological standards combined with a respectful, transparent, and supportive editorial approach. In an era where publishing can feel more burdensome than research itself, this platform restores the original purpose of peer review — to refine ideas, not to obstruct them Prof. Perlat Kapisyzi, FCCP PULMONOLOGIST AND THORACIC IMAGING.
Dear Mayra Duenas, Editorial Coordinator of the journal IJCCR, I write here a little on my experience as an author submitting to the International Journal of Clinical Case Reports and Reviews (IJCCR). This was my first submission to IJCCR and my manuscript was inherently an outsider’s effort. It attempted to broadly identify and then make some sense of life’s under-appreciated mysteries. I initially had responded to a request for possible submissions. I then contacted IJCCR with a tentative topic for a manuscript. They quickly got back with an approval for the submission, but with a particular requirement that it be medically relevant. I then put together a manuscript and submitted it. After the usual back-and-forth over forms and formality, the manuscript was sent off for reviews. Within 2 weeks I got back 4 reviews which were both helpful and also surprising. Surprising in that the topic was somewhat foreign to medical literature. My subsequent updates in response to the reviewer comments went smoothly and in short order I had a series of proofs to evaluate. All in all, the whole publication process seemed outstanding. It was both helpful in terms of the paper’s content and also in terms of its efficient and friendly communications. Thank you all very much. Sincerely, Ted Christopher, Rochester, NY.
Dear Grace Pierce, Editorial Coordinator of the journal IJCCR, I had a very positive experience with Auctores - Journal throughout the publication process. The Editorial Team was highly responsive, professional, and supportive at every stage. I would like to extend my sincere thanks to the Editor: Grace Pierce, for her guidance and assistance. The peer-review process was smooth and constructive, helping improve the quality of my work. I would gladly recommend Auctores Journal to fellow researchers and authors. Dr. SABITA SINHA, Medical Oncologist, MD (Electro Homeopathy).
Dear Maria Emerson, Editorial Coordinator of - Journal of Clinical Research and Reports. ''I am pleased to provide this testimonial following the publication of our recent case report in this journal. The peer review process was rigorous, constructive, thorough, and conducted in a timely manner. The reviewers’ comments were thoughtful, detailed, and highly constructive, contributing substantially to the refinement, clarity, and scientific robustness of our manuscript. The process was conducted with professionalism and academic integrity throughout. The support provided by the editorial office was exemplary. Communication was consistently prompt, clear, and courteous at all stages of the submission and publication process. The editorial team demonstrated a high level of organization and responsiveness, ensuring that all queries were addressed efficiently and that the process remained transparent and well-coordinated. The overall quality of the journal is reflected in its strong editorial standards, commitment to scientific excellence, and dedication to publishing clinically meaningful research. It has been a privilege to publish our work in this journal, and we would welcome the opportunity to contribute further in the future.'' Best wishes from, Dr. Trogkanis Efstratios, Cardiologist.
