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Background  With over a decade of directed efforts to reduce sex and racial differences in coronary artery bypass grafting ( CABG ) utilization, and post‐ CABG  outcomes, we sought to evaluate how the use of  CABG  and its outcomes have evolved in different sex and racial subgroups.    Methods and Results  Using data on all fee‐for‐service Medicare beneficiaries undergoing  CABG  in the United States from 1999 to 2014, we examined differences by sex and race in calendar‐year trends for  CABG  utilization and post‐ CABG  outcomes (in‐hospital, 30‐day, and 1‐year mortality and 30‐day readmission). A total of 1 863 719 Medicare fee‐for‐service beneficiaries (33.6% women, 4.6% black) underwent  CABG  from 1999 to 2014, with a decrease from 611 to 245  CABG  procedures per 100 000 person‐years. Men compared with women and whites compared with blacks had higher  CABG  utilization, with declines in all subgroups. Higher post‐ CABG  annual declines in mortality (95% confidence interval) were observed in women (in‐hospital, −2.70% [−2.97, −2.44]; 30‐day, −2.29% [−2.54, −2.04]; and 1‐year mortality, −1.67% [−1.88, −1.46]) and blacks (in‐hospital, −3.31% [−4.02, −2.60]; 30‐day, −2.80% [−3.49, −2.12]; and 1‐year mortality, −2.38% [−2.92, −1.84]), compared with men and whites, respectively. Mortality rates remained higher in women and blacks, but differences narrowed over time. Annual adjusted 30‐day readmission rates remained unchanged for all patient groups.    Conclusions  Women and black patients had persistently higher  CABG  mortality than men and white patients, respectively, despite greater declines over the time period. These findings indicate progress, but also the need for further progress.

Sex and Race Differences in the Utilization and Outcomes of Coronary Artery Bypass Grafting Among Medicare Beneficiaries, 1999–2014