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ISSN 0188-2198 (Print)

2001, Number 2

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Rev Mex Cardiol 2001; 12 (2)

Differences and outcomes of percutaneous coronary revascularization in women and men

Reyes-Cisneros FA, Farell-Campa J, Abundes-Velasco A, Palomo-Villada JA, Montoya-Guerrero AS, Necoechea AJC, Ledesma-Velasco M

Language: Spanish
References: 39
Page: 71-76
PDF size: 161.21 Kb.


ABSTRACT

Background: There are controversy in-hospital and long-term outcomes of women who undergo percutaneous coronary revascularization, showing a numerous adverse conditions to poor results. Objective: This study analyzes in-hospital and long-term outcomes among women and men underwent contemporary percutaneous coronary revascularization procedures in our department. Methods: From February 1995 through February 1999 we analyzed retrospectively consecutive 1,027 patients underwent percutaneous coronary revascularization procedures, 240 (23.4%) women and 787 (76.6%) men. Results: Conventional angioplasty in 541 patients (132 women and 378 men), and stent implantation in 486 patients (108 women and 378 men) were performed. The women more often had hypertension (58.3% vs 40.2%, p‹ 0.05) and diabetes mellitus (33.8% vs 22.1%, p= 0.04) than men. Clinical success was similar between gender (83.8% women vs 86% men), with in-hospital mortality of 5.8% and 2.4% respectively (p= NS). Follow-up was complete for 95.8% of patients for a mean of 26 months (range 6 to 46 months). Event-free survival was similar (88.1% vs 88.8% p= NS). There was no difference concerning repeated revascularization procedures. Conclusions: Despite that women had a higher risk profiles, the success rate and mid-term outcomes are similar than men.


REFERENCES

  1. Ayanian JZ, Epstein AM. Differences in the use of procedures between women and men hospitalized for coronary heart disease. N Engl J Med 1991; 325: 221-225.

  2. Steingart RM, Packer M, Hamm P, Coglianese ME, Gersh B, Geltman EM. The Ventricular enlargement investigators. Sex differences in the management of coronary artery disease. N Engl J Med 1991; 325: 226-230.

  3. Eaker E, Chesebro J, Sacks F, Wenger N, Whisnant J, Winston M. Cardiovascular disease in women. Circulation 1993; 87: 1030-1032.

  4. Fetters JK, Peterson ED, Shaw IJ, Newby K, Califf RM. Sex-specific differences in coronary artery disease risk factors, evaluation, and treatment: have they been adequately evaluated?. Am Heart J 1996; 131: 796-13.

  5. Loop FD, Golding LR, Macmillan JP, Cosgrove DM, Lyle BW, Sheldow WC. Coronary artery surgery in women compared with men: analysis of risks and long term results. J Am Coll Cardiol 1983; 1: 383-390.

  6. Eaker ED, Kronmal R, Kennedy JW, Davis K. Comparison of the long term, postsurgical survival of women and men in the Coronary Artery Surgery Study (CASS). Am Heart J 1989; 117: 71-81.

  7. Weintraub WS, Wenger NK, Jones EL, Craver JM, Guyton RA. Changing clinical characteristics of coronary surgery patients: differences between men and women. Circulation 1993; 88 (pt 2): II-79-II-86.

  8. Kelsey SF, Jame M, Holubkov AL, Holubkov R, Cowley MJ, Detre KM. Results of percutaneous transluminal coronary angioplasty in women. 1985-1986 National Heart , Lung, and Blood Insitute’s Coronary Angioplasty Registry. Circulation 1993; 87: 720-727.

  9. Bell MR, Holmes DR, Berger PB, Garratt KN, Bailey KR, Gersh BJ et al. The changing in-hospital mortality of women undergoing percutaneous transluminal coronary angioplasty. JAMA 1993; 269: 2091-2095.

  10. Stone GW, Grines CL, Browne KF, Marco J, Rothbaum D, O’Kefee J et al. Comparison of in-Hospital outcome in men versus women treated by either thrombolytic therapy or primary coronary angioplasty for acute myocardial infarction. Am J Cardiol 1995; 75: 987-992.

  11. Arnold AM, Mick MJ, Piedmonte MR, Simpferdorfer C. Gender differences for coronary angioplasty. Am J Cardiol 1994; 74: 18-21.

  12. Weintraub WS, Wenger NK, Kosinski AS, Douglas JS, Liberman HA, Morris DC et al. Percutaneous transluminal coronary angioplasty in women compared with men. J Am Coll Cardiol 1994; 24: 81-89.

  13. Kahn JK, Rutherford BD, McConahay DR, Johnson WL, Giorgi LV, Shimsak TM et al. Comparison of procedural results and risks of coronary angioplasty in men and women for conditions other than acute myocardial infarction. Am J Cardiol 1992; 69: 1241-1242.

  14. Hussain KM, Estrada AQ, Kogan A, Dadkhah S, Foschi A. Trends in success rate after percutaneous transluminal coronary angioplasty in men and women with coronary artery disease. Am Heart J 1997; 134: 719-727.

  15. Bell MR, Grill DE, Garrat KN, Berger PB, Gersh BJ, Holmes DR. Long-term outcome of women compared with men after successful coronary angioplasty. Circulation 1995; 91: 2876-2881.

  16. Jacobs AK, Faxon DP, Pinkerton CA, McKeever LS, Martin HF, Simonton CA et al. Impact of gender on outcome following percutaneous coronary revascularization: The CAVEAT Experience. Circulation 1993; 88: 4:I-448.

  17. Mehta S, Margolis JR, Bejarano J, Kennard ED, Steenkiste AR. Acute and long-term results with new devices not demonstrate significant gender differences: Results from NACI registry. Circulation 1993; 88: 4:I-448.

  18. Bowling BA, May M, Lichtenberg A, Strzelecki M, Grines CL, Safian R et al. Clinical and angiographic outcomes of new interventional devices in men and women. Circulation 1993; 88: 4: I-448.

  19. Dean LR, Voorhes WD, Sutor C, Roubin GS. Female gender: a risk factor for complications following intracoronary stenting? A Cook Multi-center Registry Report. Circulation 1994; 90: 4, Part 2: I-620.

  20. Henson KD, Popma JJ, Satler LF, Kent KM, Pichard AD, Campbell AN et al. Late clinical outcomes after new devices angioplasty in women. J Am Coll Cardiol 1993; 21: 2:233 A.

  21. Campeau L. Grading of angina pectoris. Circulation 1976; 54: 522-523.

  22. Ryan T, Faxon D, Gunnar R, Kennedy J, King S, Loop P et al. Guidelines for percutaneous transluminal coronary angioplasty. A report of the American College of Cardiology/American Heart Association. Task Force on assessment of diagnostic and therapeutic cardiovascular procedures (subcommittee on percutaneous transluminal balloon angioplasty). Circulation 1988; 78: 486-502.

  23. Douglas JS, King SB III. Techniques of percutaneous transluminal angioplasty and atherectomy of the coronary arteries. En: Schlant RC, Alexander RW, editors. Hurst’s The Heart. 8a ed. New York: McGraw-Hill, 1994: 1345-1358.

  24. Ledesma M, Farell J, Astudillo R, Abundes A, Escudero X, Antezana J et al. Stents: Experiencia en el Hospital de Cardiología del Centro Médico Nacional Siglo XXI. Arch Inst Cardiol Mex 1997; 67: 101-105.

  25. Barret-Connor E, Bush TL. Estrogen and coronary heart disease in women. JAMA 1995; 265: 1861-1867.

  26. Rozenman Y, Gilon D, Zelingher J, Sapoznikov D, Lotan C, Mosseri M et al. Age- and gender-related differences in success, major and minor complication rates and the duration of hospitalization after percutaneous transluminal coronary angioplasty. Cardiology 1996; 87: 396-401.

  27. Davies MJ. The composition of coronary plaques. N Engl J Med 1997; 336: 1312-1314.

  28. Greenberg M, Mueller H. Why the excess mortality in women after PTCA? Circulation 1993; 87: 1030-1032.

  29. Habu-Halawa S, Thompson K, Kirkeeide R, Vaughn W, Rosales O, Fujisi K et al. Estrogen replacement therapy and outcome of coronary balloon angioplasty in postmenopausal women. Am J Cardiol 1998; 82: 409-413.

  30. Kornowski R, Lansky A, Mintz G, Kent K, Pichard A, Satler L et al. Comparison of men versus women in cross-sectional area luminal narrowing , quantity of plaque, presence of calcium in plaque, and lumen location in coronary arteries by intravascular ultrasound in patients with stable angina pectoris. Am J Cardiol 1997; 79: 1601-1605.

  31. Bergelson BA, Tommaso C. Gender differences in percutaneous interventional therapy of coronary artery disease. Cathet Cardiovasc Diagn 1996; 37: 1-4.

  32. Jacobs A, Kelsey S, Brooks M, Faxon D, Chaitman B, Bittner V et al. Better outcome for women compared with men undergoing coronary revascularization. A report from the Bypass Angioplasty Revascularization Investigation (BARI). Circulation 1998; 98: 1279-1285.

  33. Malenka D, O’Rourke D, Miller M, Hearne M, Shubrooks S, Kellet Jr M et al. Cause of in-hospital death in 12,232 consecutive patients undergoing percutaneous transluminal coronary angioplasty. Am Heart J 1999; 137: 632-638.

  34. Ellis S, Roubin G, King S, Douglas J, Weintraub W, Thomas R et al. Angiographic and clinical predictors of acute closure after native vessel coronary angioplasty. Circulation 1988; 77: 372-379.

  35. Dodge J, Brown G, Bolson E, Dodge H. Lumen diameter of normal human coronary arteries. Influence of age, anatomic variation, and left ventricular hypertrophy or dilatation. Circulation 1992; 86: 232-246.

  36. O’Connor G, Morton J, Diehl M, Olmstead E, Coffin L, Levy D et al. Differences between men and women in hospital mortality associated with coronary artery bypass graft surgery. Circulation 1993; 88: 2104-2110.

  37. Airaksinen K, Ikaheimo M, Linnaluoto M, Tahvanainen K, Huikuri H. Gender differences in autonomic and hemodynamic reactions to abrupt coronary occlusion. J Am Coll Cadiol 1998; 31: 301-306.

  38. Ruygrok P, de Jaegere P, van Domburg R, van den Brand M, Serruys P, de Feyter P. Women fare no worse than men 10 years after attempted coronary angioplasty. Catheter Cardiovasc Diagn 1996; 39: 9-15.

  39. Healy B. The Yentl syndrome (Editorial). N Engl J Med 1991; 3: 274-276.




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