Sex Differences in Long-Term Outcomes in Patients With Chronic Coronary Syndrome After Percutaneous Coronary
Naoyuki Akashi1, Tetsuya Matoba2, Takahide Kohro3
1Division of Cardiovascular Medicine, Jichi Medical University Saitama Medical Center.
Insights
This study found no significant sex differences in major adverse cardiovascular events (MACE) for patients with chronic coronary syndrome (CCS) after percutaneous coronary intervention (PCI). Long-term outcomes were similar for men and women following the procedure.
Area of Science:
- Cardiology
- Interventional Cardiology
- Clinical Outcomes Research
Background:
- Sex differences in coronary artery disease (CAD) outcomes are reported but inconsistent for chronic coronary syndrome (CCS).
- Previous studies show varied long-term outcomes for men and women with CCS.
- This research addresses the need for clarity on sex-based long-term results after PCI in CCS patients.
Purpose of the Study:
- To investigate potential sex differences in long-term outcomes.
- To analyze major adverse cardiovascular events (MACE) in male versus female CCS patients post-PCI.
- To provide evidence-based insights into sex-specific prognoses after coronary intervention.
Main Methods:
- Retrospective, multicenter cohort study design.
- Inclusion of 5,555 CCS patients undergoing percutaneous coronary intervention (PCI) from April 2013 to March 2019.
- Primary outcome defined as MACE (cardiovascular death, myocardial infarction, or heart failure hospitalization), with a median follow-up of 917 days.
Main Results:
- The overall incidence of MACE did not differ significantly between men and women.
- Multivariable Cox regression analyses across four models confirmed no statistically significant sex-based disparities in MACE.
- Hazard ratio for MACE was 1.20 (95% CI 0.97-1.47), with a log-rank P-value of 0.087.
Conclusions:
- No significant sex differences were observed in MACE for patients with CCS undergoing PCI.
- Long-term cardiovascular outcomes appear comparable between men and women with CCS post-intervention.
- Findings suggest a similar prognosis for both sexes in this patient cohort.
Background:
Several studies have reported some sex differences in patients with coronary artery diseases. However, the results regarding long-term outcomes in patients with chronic coronary syndrome (CCS) are inconsistent. Therefore, the present study investigated sex differences in long-term outcomes in patients with CCS after percutaneous coronary intervention (PCI).
Methods And Results:
This was a retrospective, multicenter cohort study. We enrolled patients with CCS who underwent PCI between April 2013 and March 2019 using the Clinical Deep Data Accumulation System (CLIDAS) database. The primary outcome was major adverse cardiovascular events (MACE), defined as a composite of cardiovascular death, non-fatal myocardial infarction, or hospitalization for heart failure. In all, 5,555 patients with CCS after PCI were included in the analysis (4,354 (78.4%) men, 1,201 (21.6%) women). The median follow-up duration was 917 days (interquartile range 312-1,508 days). The incidence of MACE was not significantly different between the 2 groups (hazard ratio [HR] 1.20; 95% confidential interval [CI] 0.97-1.47; log-rank P=0.087). After performing multivariable Cox regression analyses on 4 different models, there were still no differences in the incidence of MACE between women and men.
Conclusions:
There were no significant sex differences in MACE in patients with CCS who underwent PCI and underwent multidisciplinary treatments.
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