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Gender differences for coronary angioplasty
A M Arnold1, M J Mick, M R Piedmonte
1Department of Cardiology, Cleveland Clinic Foundation, Ohio 44195-5066.
Insights
Gender and body surface area do not significantly impact angioplasty outcomes. Women experienced better event-free survival post-angioplasty, even after accounting for body surface area, while men faced higher risks of late death and repeat procedures.
Area of Science:
- Cardiology
- Interventional Cardiology
- Health Outcomes Research
Background:
- Coronary angioplasty is a common procedure for treating coronary artery disease.
- Understanding gender-based differences in angioplasty outcomes is crucial for personalized patient care.
- Previous studies have yielded conflicting results regarding gender disparities in angioplasty outcomes.
Purpose of the Study:
- To investigate the influence of gender and body surface area on early and late outcomes following angioplasty.
- To compare procedural success, mortality, and long-term event-free survival between men and women undergoing angioplasty.
Main Methods:
- A retrospective analysis of 5,000 consecutive patients (1,274 women, 3,726 men) undergoing angioplasty.
- Assessment of baseline demographic and clinical variables, procedural outcomes, and long-term survival (mean follow-up: 4 years).
- Statistical analysis to compare outcomes between genders, adjusting for body surface area and other relevant factors.
Main Results:
- Women were older and had higher rates of diabetes, hypertension, familial coronary disease, and prior myocardial infarction compared to men.
- Procedural success rates were similar, but women had higher procedural mortality (1.1% vs. 0.3%).
- After adjusting for body surface area, women showed no increased risk; they had significantly better event-free survival, while men had higher risks of late death and repeat angioplasty.
Conclusions:
- Gender-related differences in baseline characteristics exist for patients undergoing angioplasty.
- While women had higher procedural mortality, this risk was mitigated when corrected for body surface area.
- Women demonstrated superior long-term event-free survival after angioplasty compared to men, suggesting a potentially better overall prognosis.
Abstract:
To determine if differences in early and late outcome after angioplasty were related to gender or body surface area, 5,000 consecutive patients (1,274 women and 3,726 men) were studied. Baseline variables, procedural outcome, and long-term and event-free survival were assessed. Baseline variables included age, history of hypertension, diabetes mellitus, heart failure, myocardial infarction, prior angioplasty or bypass surgery, familial coronary disease, Canadian heart classification, extent of angioplasty, left ventricular function, and body surface area. Overall and event-free survival (freedom from infarction, repeat angioplasty, bypass surgery and death) were assessed at follow-up. The results showed that, compared with men, women were older (p < 0.0001), had a higher prevalence of diabetes (p < 0.0001), familial coronary disease (p = 0.002), hypertension (p < 0.0001), prior infarction (p = 0.004), and more involvement of the anterior descending artery (p = 0.017). Whereas men had similar extents of angioplasty and worse left ventricular function (p = 0.012), women more often had unstable angina (p < 0.0001). The success rates were similar, yet women had a higher procedural mortality (1.1% women, 0.3% men, p = 0.001). When corrected for body surface area, however, women were at no greater risk than men. Follow-up was complete for 97.4% of patients (mean 4 +/- 2 years). Event-free survival was significantly better in women, even after correcting for body surface area. Men were at higher risk for late death and repeat angioplasty on follow-up.(ABSTRACT TRUNCATED AT 250 WORDS)