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Comparison of Long-Term Outcomes Following Coronary Revascularization in Men-vs-Women with Unprotected Left Main Disease.
- 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.)
- Subjects :
- Acute Coronary Syndrome epidemiology
Age Distribution
Aged
Angina, Stable epidemiology
Angina, Stable surgery
Angina, Unstable epidemiology
Angina, Unstable surgery
Comorbidity
Coronary Angiography
Coronary Artery Disease epidemiology
Coronary Artery Disease pathology
Diabetes Mellitus drug therapy
Diabetes Mellitus epidemiology
Drug-Eluting Stents
Humans
Hypertension epidemiology
Hypoglycemic Agents therapeutic use
Insulin therapeutic use
Lung Diseases epidemiology
Mammary Arteries transplantation
Middle Aged
Myocardial Infarction epidemiology
Myocardial Revascularization
Non-ST Elevated Myocardial Infarction epidemiology
Non-ST Elevated Myocardial Infarction surgery
Peripheral Arterial Disease epidemiology
Proportional Hazards Models
Radial Artery transplantation
ST Elevation Myocardial Infarction epidemiology
ST Elevation Myocardial Infarction surgery
Severity of Illness Index
Sex Factors
Stroke epidemiology
Acute Coronary Syndrome surgery
Coronary Artery Bypass methods
Coronary Artery Disease surgery
Percutaneous Coronary Intervention methods
Subjects
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