scholarly journals Frequency and outcomes of aortocoronary dissection during percutaneous coronary intervention of chronic total occlusions

2013 ◽  
Vol 84 (4) ◽  
pp. 670-675 ◽  
Author(s):  
Deborah Shorrock ◽  
Tesfaldet T. Michael ◽  
Vishal Patel ◽  
Anna Kotsia ◽  
Bavana V. Rangan ◽  
...  
Keyword(s):  
Percutaneous Coronary Intervention ◽  
Coronary Intervention ◽  
Chronic Total Occlusions ◽  
Percutaneous Coronary ◽  
Aortocoronary Dissection

The impact of gender on outcomes in patients with chronic total coronary occlusions undergoing percutaneous coronary intervention: results from a Dutch nationwide registry including 7560 patients

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
A Van Veelen ◽  
J Elias ◽  
I.M Van Dongen ◽  
J.P.S Henriques ◽  
P Knaapen
Keyword(s):  
Cardiovascular Disease ◽  
Percutaneous Coronary Intervention ◽  
Survival Curve ◽  
Coronary Intervention ◽  
Chronic Total Occlusions ◽  
Nationwide Registry ◽  
Percutaneous Coronary ◽  
Baseline Characteristics ◽  
Gender Based ◽  
The Impact

Abstract Background Females comprise a minority of patients with chronic total occlusions (CTO). It is known that men have a greater benefit from CTO percutaneous coronary intervention (PCI) than women. We aimed to determine gender-based differences in baseline characteristics and outcomes after PCI in patients with CTO. Methods The Netherlands Heart Registration (NHR) is a nationwide registry that registers outcomes of cardiac interventions. For the purpose of this analysis, the data of all patients undergoing PCI from inception of the NHR to December 2018 were selected, that included PCI with at least one CTO in one of the treated coronary arteries. We compared baseline characteristics and the outcomes 1 year mortality, 30 day myocardial infarction (MI) and target vessel revascularization (TVR) <1 year between men and women. Results A total of 7560 patients were identified that underwent PCI between January 1, 2015 and December 31, 2018 with at least 1 CTO in the treated vessel. A total of 5850 was male (77.4%) and 1710 was female (22.6%). Women were older (68.5±10.6 versus 64.7±10.6 years old, p<0.001), and more frequently had diabetes (29.4% [n=529] versus 25.0% [n=1602], p<0.001) and kidney disease (4.5% [n=529] versus 2.2% [n=142], p<0.001). However, men had more extensive cardiovascular disease, i.e. multi-vessel disease (56.0% [n=3584] versus 50.4% [n=912], p<0.001), previous MI (39.7% [n=2527] versus 31.0% [n=555], p<0.001), previous PCI (48.2% [n=1967] versus 40.2% [n=455], p<0.001) and previous coronary artery bypass grafting (16.8% [n=1085] versus 10.5% [n=191], p<0.001) and more frequently presented with an out-of-hospital cardiac arrest, compared to women (2.1% [n=136] versus 1.1% [n=20], p=0.004). The 1-year mortality was higher in women (10.3% versus 7.5%, p<0.001), as well as the 30-day MI (0.9% versus 0.4%, p=0.043), but men had higher risk for TVR<1 year (11.7% versus 9.5%, p=0.044). Corrected for age and comorbidities, female gender was an independent predictor for mortality (Figure 1; odds ratio 1.83, 95% confidence interval 1.08–3.11, p=0.025). Conclusion In this nationwide registry comprising 7560 CTO patients undergoing PCI, significant gender-based differences were found. Males were found to have more extensive cardiovascular disease. However, females were at higher risk of mortality, possibly due to higher age and higher prevalence of concomitant comorbidities. Figure 1. Survival curve Funding Acknowledgement Type of funding source: None

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