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Sex-Based Differences in Chronic Total Occlusion Management

Amy Cheney1, Kathleen E Kearney2, William Lombardi2

  • 1Division of Cardiology, University of Washington, Seattle, WA, USA. aec1@cardiology.washington.edu.

Current Atherosclerosis Reports
|November 9, 2018
PubMed

Insights

This review highlights that women are underrepresented in chronic total occlusion (CTO) studies. Sex-based differences in CTO management, complications, and outcomes require further investigation.

Area of Science:

  • Cardiology
  • Interventional Cardiology
  • Health Services Research

Background:

  • Chronic total occlusions (CTOs) represent a significant subset of coronary artery disease (CAD), affecting 30-52% of patients undergoing coronary angiography.
  • Percutaneous coronary intervention (PCI) for CTOs is increasingly common and successful.
  • Existing research shows gender disparities in CAD presentation and outcomes after routine PCI, but CTO-specific differences are less understood.

Purpose of the Study:

  • To review and summarize existing data on sex-based differences in the management and outcomes of CTO percutaneous coronary intervention (PCI).
  • To identify knowledge gaps regarding gender-specific factors in CTO treatment.

Main Methods:

  • Systematic review of available data from CTO registries and clinical trials.
  • Analysis of sex-based representation in study populations.
  • Examination of reported differences in complication rates, collateral formation, and clinical outcomes.

Main Results:

  • Women constitute approximately 20% of participants in CTO registries and trials, mirroring their underrepresentation in general PCI studies.
  • Sex-based variations are observed in complication rates, collateral vessel development, and overall outcomes.
  • Current data suggests potential differences in CTO management and outcomes between sexes.

Conclusions:

  • Women are underrepresented in chronic total occlusion (CTO) research and clinical trials.
  • Significant sex-based differences exist in CTO management, including complication rates and collateralization.
  • Further research is crucial to fully elucidate and address gender-specific aspects of CTO PCI for improved patient care.

Keywords:
Chronic total occlusions (CTOs)Coronary artery bypass graft (CABG)Coronary artery disease (CAD)Percutaneous coronary intervention (PCI)ST elevation MI (STEMI)

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