Comparison of Long-Term Outcomes Following Coronary Revascularization in Men-vs-Women with Unprotected Left Main Disease

Autor: Duk-Woo Park, Ah-Ram Kim, Jeen Hwa Lee, Do-Yoon Kang, Junghoon Lee, Hanbit Park, Ju Hyeon Kim, Hyeon Jeong Oh, Yeong Jin Jeong, Sangwoo Park, Junho Hyun, Pil Hyung Lee, Mihee Jang, Yeon Jeong Lee, Tae Oh Kim, Seung-Jung Park, Taesun Kim, Jung-Min Ahn, Yujin Yang
Rok vydání: 2021
Předmět:
Lung Diseases
Acute coronary syndrome
medicine.medical_specialty
medicine.medical_treatment
Myocardial Infarction
Comorbidity
Coronary Artery Disease
Coronary Angiography
Revascularization
Severity of Illness Index
Coronary artery disease
Peripheral Arterial Disease
Age Distribution
Percutaneous Coronary Intervention
Sex Factors
Internal medicine
Diabetes Mellitus
Myocardial Revascularization
medicine
Humans
Hypoglycemic Agents
Insulin
Angina
Stable
Angina
Unstable
cardiovascular diseases
Myocardial infarction
Acute Coronary Syndrome
Coronary Artery Bypass
Mammary Arteries
Non-ST Elevated Myocardial Infarction
Stroke
Aged
Proportional Hazards Models
business.industry
Hazard ratio
Percutaneous coronary intervention
Drug-Eluting Stents
Middle Aged
medicine.disease
Hypertension
Radial Artery
Conventional PCI
Cardiology
ST Elevation Myocardial Infarction
Cardiology and Cardiovascular Medicine
business
Zdroj: The American Journal of Cardiology. 153:9-19
ISSN: 0002-9149
DOI: 10.1016/j.amjcard.2021.05.016
Popis: Gender differences have been recognized in several aspects of coronary artery disease (CAD). However, evidence for gender differences in long-term outcomes after left main coronary artery (LMCA) revascularization is limited. We sought to evaluate the impact of gender on outcomes after percutaneous coronary intervention (PCI) or coronary artery bypass grafting (CABG) for unprotected LMCA disease. We evaluated 4,320 patients with LMCA disease who underwent CABG (n = 1,456) or PCI (n = 2,864) from the Interventional Research Incorporation Society-Left MAIN Revascularization registry. The primary outcome was a composite of death, myocardial infarction (MI), or stroke. Among 4,320 patients, 968 (22.4%) were females and 3,352 (77.6%) were males. Compared to males, females were older, had a higher prevalence of hypertension and insulin-requiring diabetes, more frequently presented with acute coronary syndrome, but had less extensive CAD and less frequent left main bifurcation involvement. The adjusted risk for the primary outcome was not different after PCI or CABG in females and males (hazard ratio [HR] 1.09; 95% confidence interval [CI]: 0.73-1.63 and HR 0.97; 95% CI: 0.80-1.19, respectively); there was no significant interaction between gender and the revascularization strategy (P for interaction = 0.775). In multivariable analysis, gender did not appear to be an independent predictor for the primary outcome. In revascularization for LMCA disease, females and males had a comparable primary composite outcome of death, MI, or stroke with either CABG or PCI without a significant interaction of gender with the revascularization strategy.
Databáze: OpenAIRE
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