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Immediate results of percutaneous coronary interventions - comparative study between men and women.
Artur Kocurek, Krzysztof Żmudka, Wiesława Tracz1, Wiesława Piwowarska2, Jacek Dubiel3, Kalina Kawecka-Jaszcz4, Antoni Dziatkowiak5, Tadeusz Przewłocki1, Piotr Pieniążek1, Grzegorz Gajos2
Zakład Hemodynamiki i Angiokardiografii CMUJ; 1Klinika Chorób Serca i Naczyń; 2Klinika Choroby Wieńcowej; 3II Klinika Kardiologii; 4I Klinika Kardiologii; 5Klinika Chirurgii Serca i Naczyń; Kraków
Earlier reports on PCI (percutaneous coronary interventions) in women (W) described lower success with higher complication rates. To determine if gender differences continue to influence short-term outcome of PCI, we compared 67 W (23%) to 224 M (77%) who underwent initial PCI between June 1997 - June 1998.
Methods and results: Baseline clinical characteristics were different in W compared to M, W were older (56 ± 8.6 vs 54 ± 9.4 yrs), had a higher incidence of obesity (71% vs 48%) and stable angina (85% vs 68%), all p < 0.05. W had less prior MI (59.7% vs 71%), prior PCI (12% vs 27%), CCS class III-IV angina (44.7% vs 68%) and unstable angina (14.9% vs 32%), all p < 0.05. No differences were found in the prior CABG, familial coronary disease, hypertension, diabetes mellitus, dyslipidemia.W and M had similar manifestations of angiographically defined CAD, LV EF, severity of stenosis and similar incidence of type A and B lesions. More M had type C lesions (16% vs 7%, p=0.022) and W had smaller target vessel size (2.92 ± 0.49 vs 3.048 ± 0.26 mm, p<0.019). Rates of procedural success on a per-lesion basis were similar for W and M (85.3% vs 88%). There were no significant differences in major complication rates between W and M: Q-wave MI (0% vs 0.28%), emergency CABG (0.97% vs 0.28%), in-hospital mortality (0% vs 0%). W had a higher incidence of coronary dissections (72.8% vs 36.6%, p<0.000), coronary branch occlusions (4.85% vs 0.57%, p=0.008) and developed more peripheral vascular complications (7.76% vs 1.42%, p=0.05) but overall frequency of minor complications was not different (27.2% vs 20.45%). The length of hospital stay connected with PCI procedures tended to be shorter for M (10.11 vs 18.37 days, p<0.000).
Conclusions: 1\ The procedural outcome and in-hospital complications of coronary angioplasty are similar in W and M. 2\ W are less frequently referred for PCI procedures. 3\ Female gender adversely affect length of hospital stay connected with PCI procedures.
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© Copyright by Polskie Towarzystwo Kardiologiczne 2001
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