Sex differences in clinical outcomes after rotational atherectomy of calcified coronary stenoses: from multicenter registry.

Autor:	Otsuki H; Department of Cardiology, Tokyo Women's Medical University Japan., Jujo K; Department of Cardiology, Tokyo Women's Medical University Japan., Tanaka K; Department of Cardiology, Tokyo Women's Medical University Japan., Okai I; Department of Cardiovascular Medicine, Juntendo University School of Medicine Japan., Nakashima M; Department of Cardiology, Teikyo University School of Medicine Japan., Dohi T; Department of Cardiovascular Medicine, Juntendo University School of Medicine Japan., Okazaki S; Department of Cardiovascular Medicine, Juntendo University School of Medicine Japan., Okabe R; Department of Cardiology, Teikyo University School of Medicine Japan., Nagura F; Department of Cardiology, Teikyo University School of Medicine Japan., Nara Y; Department of Cardiology, Teikyo University School of Medicine Japan., Kawashima H; Department of Cardiology, Teikyo University School of Medicine Japan., Kyono H; Department of Cardiology, Teikyo University School of Medicine Japan., Arashi H; Department of Cardiology, Tokyo Women's Medical University Japan., Yamaguchi J; Department of Cardiology, Tokyo Women's Medical University Japan., Tamura H; Department of Cardiovascular Medicine, Juntendo University School of Medicine Japan., Kurata T; Department of Cardiovascular Medicine, Juntendo University School of Medicine Japan., Miyauchi K; Department of Cardiovascular Medicine, Juntendo University School of Medicine Japan., Kozuma K; Department of Cardiology, Teikyo University School of Medicine Japan., Daida H; Department of Cardiovascular Medicine, Juntendo University School of Medicine Japan., Hagiwara N; Department of Cardiology, Tokyo Women's Medical University Japan.
Jazyk:	angličtina
Zdroj:	American journal of cardiovascular disease [Am J Cardiovasc Dis] 2021 Feb 15; Vol. 11 (1), pp. 12-20. Date of Electronic Publication: 2021 Feb 15 (Print Publication: 2021).
Abstrakt:	Background: Recent improvements in devices and medications may diminish the risk of adverse events following percutaneous coronary intervention (PCI) in women. However, complex calcified coronary lesions are increasingly being encountered in clinical practice, which remain challenging for contemporary PCI. Rotational atherectomy (RA) of severely calcified lesions is an option that facilitates the technical success of PCI. We aimed to examine sex differences in long-term clinical prognoses after PCI with RA in the drug-eluting stent (DES) era. Methods and Results: We evaluated J2T ROTA registry data from 1,090 patients with severely calcified de novo coronary artery stenoses who underwent PCI using RA at 3 hospitals between 2004 and 2015. After excluding patients who received regular hemodialysis, 788 patients, including 570 men and 218 women, were ultimately analyzed. The primary endpoint was major adverse cardiovascular and cerebrovascular events (MACCE), which included death, acute coronary syndrome (ACS), and stroke. The women were significantly older, and presented more frequently with chronic kidney disease, ACS, atrial fibrillation, lower body mass indexes, and worse lipid profiles than the men. During the observation period, MACCE occurred in 197 patients (25%) (118 deaths, 29 strokes, and 50 ACS). In the unmatched population, women had a higher MACCE rate than men (hazard ratio: 1.48, [95% confidence interval: 1.07-2.06]). However, sex was not associated with MACCE in the propensity score-matched population. Conclusion: In the DES era, differences between sexes were not observed in relation to long-term MACCE in patients undergoing PCI with RA for severely calcified coronary artery stenoses. Competing Interests: Juntendo University School of Medicine (Dr. Okai, Dr. Dohi, Dr. Okazaki, Dr. Tamura, Dr. Miyauchi, and Dr. Daida) and Teikyo University School of Medicine (Dr. Nakashima, Dr. Okabe, Dr. Nagura, Dr. Nara, Dr. Kawashima, Dr. Kyono, and Dr. Kozuma) received institutional research funds from Boston Scientific Japan. Dr. H. Kyono and K Kozuma have received modest honorarium for lecture from Boston Scientific Japan. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose. (AJCD Copyright © 2021.)
Databáze:	MEDLINE
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