Abstract 915: The Effect of Gender and Race on Outcomes in Patients Undergoing PCI for Proximal Coronary Artery Lesions: A Report from the NHLBI Dynamic Registry of PCI
Background: Little is known about the effect of gender and race on outcomes in patients after revascularization of proximal coronary lesions (PCL). We investigated their effect on outcomes using the NHLBI Dynamic Registry.
Methods: Of the 9962 patients receiving PCI, 3918 (39%) were treated for disease in a proximal coronary artery segment. Left main and PCI for graft lesions were excluded. Primary outcomes were death/MI or need for repeat revascularization at 1 year after the index procedure.
Results: 80% of the patients were white (n=3144), 11% black (n=469), 63% male (n=2461), and 37% female (n=1457). Patients with PCL had lower rates of HTN, prior MI, but where older and had more concomitant medical disease. Compared to non-proximal lesions, patients with PCL had higher rate of death (5.4% vs. 4%, p=0.001) and repeat revascularization (16.3% vs. 14.3%, p=0.01). The effect of gender and race were then included in the multivariate model for predicting risk in patients with PCL (Table 1⇓). Race did not modify the risk associated with PCL but females had a 32% greater relative risk (p=0.002) of repeat revascularization when compared to men.
Conclusions: Treatment of proximal coronary lesions is associated with a more adverse outcomes compared to non-proximal coronary lesions. In this high-risk population, female gender is an independent predictor for the need for repeat revascularization.