Comparison of Outcomes in Men Versus Women After Percutaneous Coronary Intervention for Chronic Total Occlusion

Am J Cardiol. 2017 Jun 15;119(12):1931-1936. doi: 10.1016/j.amjcard.2017.03.021. Epub 2017 Mar 29.

Abstract

Conflicting evidence exists on gender differences in outcomes after coronary stenting, and gender-based data in patients with chronic total occlusions (CTO) who underwent percutaneous coronary intervention (PCI) are scarce. Consecutive patients who underwent CTO PCI from January 2005 to December 2013 were included in the analysis and stratified according to gender. The primary outcome measure was all-cause mortality. Median follow-up was 2.6 years (interquartile range 1.1 to 3.1). Of 2002 patients, 332 (17%) were women. Procedural success was achieved in 82% and 83% of women and men (p = 0.31). All-cause mortality was 15% and 11% in women and men (log-rank p = 0.17) with an adjusted hazard ratio of 0.85 (95% confidence interval [CI] 0.61 to 1.17, p = 0.31). All-cause mortality was significantly reduced in patients with procedural success, both in women (12% vs 32%, adjusted hazard ratio 0.44, 95% CI 0.24 to 0.79, p = 0.006) and men (9% vs 21%, adjusted hazard ratio 0.64, 95% CI 0.47 to 0.88, p = 0.006), with similar mortality benefits associated with successful revascularization in both groups (interaction p = 0.35). In conclusion, recanalization of coronary arterial CTO is equally successful in both women and men.

Publication types

  • Comparative Study

MeSH terms

  • Age Factors
  • Aged
  • Cause of Death / trends
  • Chronic Disease
  • Coronary Angiography
  • Coronary Occlusion / diagnosis
  • Coronary Occlusion / mortality
  • Coronary Occlusion / surgery*
  • Female
  • Follow-Up Studies
  • Germany / epidemiology
  • Humans
  • Incidence
  • Kaplan-Meier Estimate
  • Male
  • Middle Aged
  • Percutaneous Coronary Intervention*
  • Postoperative Complications / epidemiology*
  • Registries*
  • Retrospective Studies
  • Risk Assessment / methods*
  • Risk Factors
  • Sex Distribution
  • Sex Factors
  • Survival Rate / trends
  • Time Factors
  • Treatment Outcome