Coronary angioplasty and surgical revascularization: emerging concepts

Early reports from the NHLBI PTCA Registry showed that women undergoing percutaneous transluminal coronary angioplasty (PTCA) had lower acute success rates and higher procedural complication rates than men. Similarly, most larger scale studies that have evaluated the differences in outcome between men and women undergoing surgical revascularization have noted a higher operative mortality rate in women. Some, but not all, of these differences are secondary to the higher baseline cardiovascular risk profile and smaller coronary artery diameter found in women. This article reviews the evolution of coronary angioplasty and bypass graft surgery as viable revascularization strategies in women with a focus on gender differences in baseline characteristics, acute outcome and long-term efficacy.