Gender differences in percutaneous coronary intervention for chronic total occlusions from the ERCTO study

Area of Science:

• Cardiology
• Interventional Cardiology
• Vascular Medicine

Background:

• Limited gender-specific data exists for percutaneous coronary intervention (PCI) in chronic total occlusion (CTO) patients.
• Previous studies on CTO-PCI in women are based on small sample sizes, necessitating larger investigations.

Purpose of the Study:

• To investigate gender-based differences in in-hospital clinical outcomes following CTO-PCI.
• To compare procedural success rates and complication profiles between female and male patients undergoing CTO-PCI.

Main Methods:

• Analysis of data from 35,449 patients in the prospective European Registry of CTOs.
• Primary outcome: procedural success rate (residual stenosis <20%, TIMI flow=3).
• Secondary outcomes: in-hospital major adverse cardiac and cerebrovascular events (MACCEs) and procedural complications.

Main Results:

• Women constituted 15.2% of the study population, were older, and had more comorbidities (hypertension, diabetes, renal failure).
• Women demonstrated a higher procedural success rate (aOR=1.115, p=0.030) with increased use of antegrade and true-to-true lumen techniques.
• Despite similar MACCE rates (0.9% vs. 0.9%, p=0.766), women experienced higher rates of procedural complications, including coronary perforation (3.7% vs. 2.9%) and vascular complications (1.0% vs. 0.6%).

Conclusions:

• Female sex is associated with improved procedural success in CTO-PCI.
• No significant gender differences were observed in in-hospital MACCEs.
• Women undergoing CTO-PCI face a higher risk of procedural complications.