Prior research has shown that women with coronary artery disease who undergo percutaneous revascularization present more comorbidities, require less aggressive treatments, have greater long-term morbidity rates and worst functional status and/or post-procedure angina.
This study used data from the CPORT-E trial (Cardiovascular Patient Outcomes Research Team Non primary Percutaneous Coronary Intervention) to assess baseline differences between sexes at 6 weeks and 9 months after the procedure.
The primary endpoint (PEP) was overall mortality at 6 weeks, while the secondary endpoint (SEP) was a composite of all-cause mortality, type Q acute myocardial infarction, and culprit vessel revascularization at 9 months.
Out of the 18,867 assessed patients, 6851 were women (36%). The women were older, more frequently of African-American origin, and had higher rates of hypertension, diabetes, heart failure, previous stroke, or peripheral vascular disease. In contrast, they had lower rates of prior angioplasty or myocardial revascularization surgery, prior myocardial infarction, and smoking.
In coronary angiography, women had more findings of single-vessel disease, and less frequently received multivessel angioplasty.
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While there were no differences between the PEP and the SEP, women had higher rates of bleeding, vascular repair, and repeat diagnostic catheterization.
Significant differences were also observed in health status (measured by a Self-Assessment Questionnaire); they presented worse health status at 6 weeks and at 9 months at the expense of higher frequency of angina, worse quality of life, and physical limitations.
Conclusion
Being female was a predictor of worse health status at 6 weeks and at 9 months after angioplasty.
Dr. Andrés Rodríguez.
Member of the Editorial Board, SOLACI.org
Original Title: Sex Differences in Health Status and Clinical Outcomes After Nonprimary Percutaneous Coronary Intervention.
Reference: Pranoti G. Hiremath et al. Circ Cardiovasc Interv. 2022;15:e011308.
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