Abstract 20362: Gender Differences in Percutaneous Coronary Intervention for Chronic Total Occlusions: a Report from the 1,781 Patient Multinational CTO Registry
Introduction: Little is known about gender differences among patients undergoing percutaneous coronary intervention (PCI) for chronic total occlusions (CTO).
Methods: A total of 1,781 patients with 1,846 CTO underwent PCI at four centers in the US, UK, Italy and South Korea between 1998 and 2007. We compared baseline characteristics, procedural success rates (residual stenosis <50%) and 5-year clinical event rates including a composite endpoint of death or myocardial infarction (MI), and target vessel revascularization (TVR).
Results: A total of 1534 men and 247 women were treated. Women were older (66±10 years vs. 61±11 years, p<0.01), were more often smokers (82% vs 72%, p<0.01) and more often had diabetes mellitus (22% vs. 29%, p=0.01). Procedural success rates were significantly higher among women (74.5%) then among men (67.5%, P=0.03). The median follow-up duration was 2.8 years. After successful PCI, we observed a trend towards a lower incidence of death/MI among women at 5 year follow-up (7.7% vs 10.5%, p=0.06, figure 1) due to a lower incidence of in-hospital MI (0.5% vs. 2.9%, p=0.06). Kaplan-meier estimates of TVR at 5 years were comparable for both sexes (23.2% vs.23.2%, p=0.68). After unsuccessful PCI, 5-year death/MI rates were comparable between both women and men (7.8% vs. 10.9%, p=0.67).
Conclusions: In this large multinational registry, women undergoing CTO PCI were more likely to have a successful procedure. Furthermore, among patients who underwent successful CTO PCI we observed a trend towards a lower incidence of the composite endpoint of Death/MI at 5-year follow-up among women due to a lower rate of in-hospital MI.
- © 2010 by American Heart Association, Inc.