Sex Differences in Procedural Characteristics and Clinical Outcomes Among Patients Undergoing Bifurcation PCI

Area of Science:

• Interventional Cardiology
• Cardiovascular Research
• Health Outcomes

Background:

• Bifurcation percutaneous coronary intervention (PCI) outcomes differ by sex.
• Limited data exists on risk profiles and clinical outcomes for women undergoing bifurcation PCI.
• Understanding sex-based differences is crucial for personalized cardiovascular care.

Purpose of the Study:

• To compare angiographic and procedural characteristics between sexes undergoing bifurcation PCI.
• To evaluate clinical outcomes, specifically 5-year target lesion failure (TLF), based on sex.
• To determine if sex is an independent predictor of adverse outcomes in bifurcation PCI.

Main Methods:

• Analysis of the COronary BIfurcation Stenting III (COBIS III) registry, a multicenter study.
• Inclusion of 2,648 patients treated with second-generation drug-eluting stents for bifurcation lesions.
• Comparison of outcomes between women (n=635) and men (n=2013), focusing on 5-year TLF (cardiac death, myocardial infarction, target lesion revascularization).

Main Results:

• Women were older, with higher rates of hypertension and diabetes, and smaller vessel diameters than men.
• Procedural characteristics and angiographic stenoses were comparable between sexes.
• No significant difference in 5-year TLF (6.3% vs. 7.1%, p=0.63) or its components was observed; sex was not an independent predictor.

Conclusions:

• Sex is not an independent predictor of adverse outcomes in patients undergoing bifurcation PCI.
• Clinical outcomes are similar between women and men despite baseline differences.
• Findings were consistent across left main and 2-stenting subgroups.