Abstract 15831: Is Female Gender Associated With Adverse Clinical Outcome After PCI for Chronic Total Occlusions?
Introduction: little is known about gender differences among patients undergoing PCI for chronic total occlusion (CTO).
Methods: a total of 1343 consecutive patients underwent PCI at our center, between 2004 and 2013. We compared baseline characteristics, procedural features and clinical events in male and female patients.
Results: a total of 1144 men (85.6%) and 194 women (14.4%) underwent PCI for CTO with a total success rate of 71.2%. Mean follow up of 50.2±28,9 months was completed in 92.5% of patients. Women were older (Women: 68.5±9,9 vs. Men: 62.3±10.8 years old, p<0,001), and had more diabetes (W: 33.5% vs M: 26.4%, p=0,026) and hypertension (W: 70.1% vs M: 57.4%, p<0,001) than men. Men smoked more (M 28,5% vs W 15.5%, p<0,001). Success rate was similar in both sexes (70.8% in men, 73.2% in women, p=ns). All-cause mortality during follow up was 12.2% (137 cases), including 80 cases of identified or supposed cardiac death. There were no significant differences in survival between sexes (death: 13.5%W vs. 12%M). No differences were found either in the rate of major adverse cardiovascular events MACE (death, acute coronary syndromes, stroke or any need for revascularization) (18.4%W vs 18.7%M, p=ns) (Figure 1). Analysis of each individual MACE component showed that only target lesion revascularization (TLR) was significantly higher in men than in women (9.2%M vs. 3.9%W, p=0.025). If we consider only successfully revascularized patients we continue to see no differences between both sexes, except in the TLR item.
Conclusion: our study suggests an equal benefit of CTO interventions regardless of sex. However, and concordantly with other registries, women accounted for less than 15% of CTO procedures, suggesting than CTO PCI should be increasingly attempted in female patients, as these procedures have proven to be safe with a high success rate in experienced hands.
- © 2013 by American Heart Association, Inc.