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Outcomes of Complex Percutaneous Cardiac Interventions in Women
Mirvat Alasnag1, Valeria Paradies2, Nicola Ryan3
1Cardiac Center, King Fahd Armed Forces Hospital Jeddah, Saudi Arabia.
US Cardiology
|November 19, 2024
Summary
Complex percutaneous cardiac intervention (PCI) is increasing, yet data on sex and gender disparities are lacking. Women undergoing PCI face higher risks, underscoring the need for dedicated research into complex interventions for this population.
Area of Science:
- Cardiovascular Medicine
- Interventional Cardiology
- Health Disparities
Background:
- Complex percutaneous cardiac intervention (PCI) is more common in older patients with multiple comorbidities.
- Procedures include bifurcations, chronic total occlusions, and atherectomy, with outcomes data crucial for patient care.
- Existing data on sex and gender disparities in complex PCI outcomes are limited.
Purpose of the Study:
- To review the current understanding of sex and gender disparities in complex percutaneous cardiac intervention (PCI).
- To highlight challenges and identify knowledge gaps regarding women undergoing complex PCI.
- To advocate for dedicated research exploring the safety and efficacy of complex interventions in women.
Main Methods:
- Literature review and synthesis of existing data on complex PCI outcomes stratified by sex and gender.
- Analysis of trends in cardiovascular risk factors and anatomical complexity in women undergoing PCI.
- Examination of outcomes in women with specific complex PCI scenarios, including bifurcation lesions, left main stem disease, and calcified lesions.
Main Results:
- Women often present with more comorbidities and less complex coronary anatomy but have a higher risk of myocardial infarction (MI) post-PCI.
- Women show trends towards worse outcomes with PCI compared to coronary artery bypass grafting for left main stem and multivessel disease.
- Data on revascularization for women with valvular heart disease and calcified lesions are conflicted, with women facing increased ischemic risk.
Conclusions:
- Significant knowledge gaps exist regarding sex and gender differences in complex PCI outcomes.
- Women undergoing complex PCI, particularly with calcified lesions or concomitant valvular disease, face unique challenges and increased risks.
- Dedicated clinical trials are essential to address the safety and efficacy of complex interventions in women and reduce health disparities.
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