Abstract 4420: Gender Differences in Short-term Outcome After Carotid Revascularization: The CARE-Registry
Introduction: It is still unclear whether gender influences short-term outcome after carotid revascularization. The impact of gender may differ between symptomatic patients undergoing carotid endarterectomy (CEA), symptomatic patients undergoing carotid artery stenting (CAS), asymptomatic patients undergoing CEA and asymptomatic patients undergoing CAS. Our aim was to determine the influence of gender on short-term outcome in these four groups.
Methods: Patients entered into the Carotid Artery Revascularization (CARE) registry up to the first quarter of 2009 formed the basis of our analyses. Our outcome of interest was the 30-day combined outcome of death or stroke or myocardial infarction. Survival analysis was used to compare survival times between men and women and Cox proportional hazards regression analyses were performed to evaluate the influence of sex on the outcome of interest. We adjusted for age, grade of stenosis, renal failure, ischemic heart disease, hypertension, tobacco use, diabetes and dyslipidemia.
Results: There were a total of 9320 patients available for analysis. The event rate for the symptomatic CEA group was 4.7% for men and 8.0% for women (HR 1.87 95%CI 0.99 –3.53). For the symptomatic CAS group the event rate was 9.0% for men and 9.9% for women (HR 1.02 95%CI 0.73–1.41). In the asymptomatic CEA group, event rates of 4.2% for men and 5.3% for women were found (HR 1.04 95%CI 0.62–1.73) and for the asymptomatic CAS group the event rates were 5.8% for men and 4.8% for women (HR 0.72 95%CI 0.49 –1.06).
Conclusion: Our data demonstrated differences in event rates between men and women for all subgroups although not significant. The evidence for gender differences in short-term outcome was most pronounced in the symptomatic CEA group.