Comparison of characteristics and complications in men versus women undergoing chronic total occlusion percutaneous intervention

Vinoda Sharma, William Wilson, William Smith, Margaret McEntegart, Keith Oldroyd, Novalia Sidik, Alan Bagnall, Mohaned Egred, John Irving, Julian Strange, Thomas Johnson, Simon Walsh, Colm Hanratty, James Spratt (Lead / Corresponding author)

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    15 Citations (Scopus)

    Abstract

    Gender differences exist in clinical outcomes after routine percutaneous coronary intervention (PCI), but studies reporting such outcomes after chronic total occlusion (CTO) PCI are limited. We assessed the characteristics and outcomes of female patients undergoing CTO PCI. We retrospectively analyzed a dedicated national (United Kingdom) prospective CTO database from 2011 to 2015 for outcomes and characteristics of female patients undergoing CTO PCI (unmatched and propensity matched). Female patients constituted 20.5% (n = 260 of 1,271) of the unmatched cohort and 33.3% (n = 233 of 699) of the matched cohort and were more likely to be older (women aged >70 years, 48% in the unmatched and 45% in the matched cohort). An increased inhospital complication rate was observed in female patients (unmatched: 10% women vs 4.45% men, p = 0.0012, and matched 9.87% women vs 3.86% men, p = 0.0032). Coronary perforation, bleeding, and contrast-induced nephropathy were more frequently observed in female patients. Femoral access site with >6 French sheath was associated with an increased risk of bleeding. Presence of calcification in the CTO artery was associated with coronary perforation (grade III) in female patients in the matched cohort (p = 0.007). Female patients undergoing CTO PCI were older and experienced increased of inhospital complications. Increased awareness of these complications could influence the selection of access site and sheath size, the need for prehydration, judicious choice of balloon size, collateral selection, and wire placement in female patients undergoing CTO PCI.

    Original languageEnglish
    Pages (from-to)535-541
    Number of pages7
    JournalAmerican Journal of Cardiology
    Volume119
    Issue number4
    Early online date16 Nov 2016
    DOIs
    Publication statusPublished - 15 Feb 2017

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