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

Authors :
Park S
Ahn JM
Park H
Kang DY
Lee PH
Kim TO
Lee J
Kim JH
Yang Y
Jeong YJ
Hyun J
Kim AR
Kim T
Oh HJ
Lee YJ
Lee JH
Jang M
Park DW
Park SJ
Source :
The American journal of cardiology [Am J Cardiol] 2021 Aug 15; Vol. 153, pp. 9-19. Date of Electronic Publication: 2021 Jul 04.
Publication Year :
2021

Abstract

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.<br />Competing Interests: Conflict of Interest The authors have no conflicts of interest to declare.<br /> (Copyright © 2021 Elsevier Inc. All rights reserved.)

Details

Language :
English
ISSN :
1879-1913
Volume :
153
Database :
MEDLINE
Journal :
The American journal of cardiology
Publication Type :
Academic Journal
Accession number :
34233836
Full Text :
https://doi.org/10.1016/j.amjcard.2021.05.016