Comparison of outcomes for percutaneous coronary intervention in men and women with unprotected left main disease
Sheng-Wen Liu1, Chang-Dong Guan2, Feng-Huan Hu1
1Department of Cardiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences, Beijing, China.
Insights
Women undergoing unprotected left main coronary artery disease (ULMCAD) percutaneous coronary intervention (PCI) show better outcomes. This study found women had fewer major adverse cardiac events, deaths, and revascularizations compared to men after PCI.
Area of Science:
- Cardiology
- Interventional Cardiology
- Health Outcomes Research
Background:
- Percutaneous coronary intervention (PCI) for unprotected left main coronary artery disease (ULMCAD) is increasingly common.
- Limited data exists on sex-based differences in outcomes following ULMCAD PCI.
Purpose of the Study:
- To investigate the impact of sex on clinical outcomes in patients undergoing ULMCAD PCI.
- To compare major adverse cardiac events (MACE), all-cause death, myocardial infarction (MI), and revascularization rates between men and women.
Main Methods:
- Retrospective analysis of 3,960 patients (3,121 men, 839 women) who underwent ULMCAD PCI between January 2004 and December 2015.
- Clinical outcomes assessed at three-year follow-up included MACE, all-cause death, MI, and revascularization.
- Statistical analysis, including adjusted hazard ratios, was performed to compare outcomes between sexes.
Main Results:
- Unadjusted outcomes for MACE, all-cause death, MI, and revascularization were similar between women and men.
- After adjustment, male patients had significantly higher rates of MACE (HR=1.49), all-cause death (HR=1.65), and revascularization (HR=1.46) compared to female patients.
- Women demonstrated better adjusted outcomes in terms of MACE, all-cause death, and revascularization.
Conclusions:
- Women undergoing ULMCAD PCI experience superior outcomes compared to men.
- Sex is an important factor influencing outcomes in patients treated with ULMCAD PCI.
- Further research may explore underlying biological or clinical factors contributing to these sex-based differences.
Background:
Percutaneous coronary intervention (PCI) in patients with unprotected left main coronary artery disease (ULMCAD) is increasing strategy in coronary artery patients. However, there is a lack of knowledge on the impact of sex on outcomes of patients undergoing ULMCAD PCI.
Methods:
From January 2004 to December 2015, there were 3,960 patients undergoing ULMCAD PCI at our institution, including 3,121 (78.8%) men and 839 (21.2%) women. The clinical outcome included the incidence of major adverse cardiac events (MACE) (the composite of all-cause death, myocardial infarction (MI), and revascularization), all-cause death, MI, revascularization at three years follow-up.
Results:
Compared with men, women had not significantly different MACE (14.7% vs. 14.6%, P = 0.89, all-cause death (3.5% vs. 3.7%, P = 0.76), MI (5.0% vs. 4.3%, P = 0.38), revascularization (9.1% vs. 8.9%, P = 0.86), respectively. After adjustment, rates of MACE (HR = 1.49; 95% CI: 1.24-1.81;P < 0.0001) and all-cause death (HR = 1.65; 95% CI: 1.09-2.48; P = 0.017) occurred more frequently in male patients, as well as revascularization (HR = 1.46; 95% CI: 1.16-1.85;P = 0.001).
Conclusion:
In this analysis, compared to men, women undergoing ULMCAD PCI have better outcomes of MACE, all-cause death, and revascularization.
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