A Personalized Approach to Percutaneous Coronary Interventions in the Left Main Coronary Artery—Is the Female Gender Associated with Worse Outcomes?
Abstract
:1. Introduction
2. Materials and Methods
2.1. Study Population
2.2. Clinical and Angiographic Data
2.3. Study Endpoints
2.4. Statistical Analysis
3. Results
3.1. Baseline Study Population Characteristics
3.2. Procedure Details
3.3. Outcomes
4. Discussion
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Variable | Women n = 130 | Men n = 403 | p-Value |
---|---|---|---|
Age (y) | 70.0 ± 9.4 | 67.7 ± 9.2 | 0.006 |
BMI (kg/m2) | 29.1 ± 4.9 | 28.2 ± 4.4 | 0.052 |
Hypertension | 118 (90.8%) | 326 (80.9%) | 0.009 |
Hyperlipidemia | 63 (48.5%) | 202 (50.1%) | 0.742 |
Chronic kidney disease | 55 (42.3%) | 124 (30.8%) | 0.015 |
Diabetes | 59 (45.4%) | 137 (34.0%) | 0.019 |
Stroke/TIA | 7 (5.4%) | 37 (9.2%) | 0.171 |
COPD | 8 (6.2%) | 35 (8.7%) | 0.357 |
Peripheral artery disease | 19 (14.6%) | 60 (14.9%) | 0.939 |
Atrial fibrillation | 16 (12.3%) | 51 (12.7%) | 0.917 |
Cigarette smoking (current) | 46 (35.4%) | 159 (39.5%) | 0.407 |
Prior MI | 49 (37.7%) | 211 (52.4%) | 0.004 |
Prior PCI LAD | 24 (18.5%) | 98 (24.3%) | 0.167 |
Prior PCI LCx | 12 (9.2%) | 66 (16.4%) | 0.045 |
Prior PCI RCA | 33 (25.4%) | 130 (32.3%) | 0.139 |
Prior CABG | 23 (17.7%) | 92 (22.8%) | 0.216 |
Clinical presentation: | |||
Stable angina | 78 (60.0%) | 240 (59.6%) | 0.928 |
Unstable angina | 35 (26.9%) | 107 (26.6%) | 0.933 |
NSTEMI | 16 (12.3%) | 38 (9.4%) | 0.344 |
STEMI | 2 (1.5%) | 13 (3.2%) | 0.312 |
LVEDD (mm) | 47.1 ± 5.9 | 53.1 ± 7.3 | <0.001 |
LVEF (%) | 53.5 ± 9.4 | 49.5 ± 11.2 | 0.001 |
EuroScore II | 2.32 ± 1.93 | 2.29 ± 1.87 | 0.826 |
Syntax Score: | 23.5 ± 9.3 | 24.8 ± 10.2 | 0.301 |
0–22 (low) | 63 (48.5%) | 182 (45.2%) | 0.511 |
23–32 (intermediate) | 39 (30.0%) | 124 (30.8%) | 0.869 |
≥33 (high) | 28 (21.5%) | 94 (23.3%) | 0.673 |
Variable | Women n = 130 | Men n = 403 | p-Value |
---|---|---|---|
LM distal | 102 (78.5%) | 323 (80.1%) | 0.677 |
LM bifurcation | 84 (64.6%) | 256 (63.5%) | 0.828 |
LM trifurcation | 10 (7.7%) | 57 (14.1%) | 0.054 |
LM calcification | 19 (14.6%) | 55 (13.6%) | 0.781 |
LAD disease (not ostial) | 8 (6.2%) | 34 (8.4%) | 0.401 |
LCx disease (not ostial) | 9 (6.9%) | 22 (5.5%) | 0.535 |
Protected LM | 12 (9.2%) | 65 (16.1%) | 0.052 |
RCA recessive (a) | 8 (6.2%) | 30 (7.4%) | 0.619 |
RCA with significant stenosis (b) | 20 (15.4%) | 60 (14.9%) | 0.890 |
RCA total occlusion (c) | 13 (10.0%) | 85 (21.1%) | 0.005 |
Lack of RCA support (a + b + c) | 41 (31.5%) | 175 (43.4%) | 0.016 |
CTO of RCA with collateral circulation from LCA | 9 (6.9%) | 55 (13.6%) | 0.040 |
Extent of diseased vessels: | |||
LM plus 2-vessel disease | 28 (21.5%) | 109 (27.0%) | 0.211 |
LM plus 3-vessel disease | 9 (8.3%) | 54 (13.4%) | 0.047 |
Medina classification: | n = 84 | n = 256 | |
1-0-0 | 22 (26.2%) | 84 (32.8%) | 0.256 |
1-0-1 | 10 (11.9%) | 35 (13.7%) | 0.678 |
1-1-0 | 30 (35.7%) | 76 (29.7%) | 0.301 |
1-1-1 | 22 (26.2%) | 61 (23.8%) | 0.662 |
Variable | Women n = 130 | Men n = 403 | p-Value |
---|---|---|---|
PCI success | 129 (99.2%) | 402 (99.8%) | 0.984 |
Number of stents | 1.82 ± 0.93 | 1.67 ± 0.82 | 0.097 |
Total length of implanted stents [mm] | 39.7 ± 22.8 | 38.7 ± 22.5 | 0.612 |
Radiation time [min] | 17.9 ± 8.9 | 17.8 ± 9.6 | 0.647 |
Radiation dose [mGy] | 1215 ± 812 | 1497 ± 884 | <0.001 |
Contrast volume [mL] | 242.6 ± 99.9 | 254.9 ± 92.4 | 0.166 |
Arterial access site | |||
Radial | 75 (57.7%) | 229 (56.8%) | 0.862 |
Femoral | 55 (42.3%) | 174 (43.2%) | |
Stenting LM only | 17 (13.1%) | 47 (11.7%) | 0.666 |
Stenting LM bifurcation | |||
One-stent technique | 79 (60.8%) | 278 (69.0%) | 0.083 |
Two-stent technique | 34 (26.2%) | 78 (19.4%) | 0.098 |
Two-stent techniques: | n = 34 | n = 78 | |
Crush | 16 (47.1%) | 30 (38.5%) | 0.395 |
DK-crush | 2 (5.9%) | 12 (15.4%) | 0.162 |
Cullote | 1 (2.9%) | 0 (0.0%) | 0.668 |
T-stenting | 6 (17.6%) | 16 (20.5%) | 0.726 |
Provisional stenting | 9 (26.5%) | 20 (25.6%) | 0.927 |
Variable | Women n = 130 | Men n = 403 | p-Value |
---|---|---|---|
Myocardial infarction | 9 (6.9%) | 14 (3.5%) | 0.092 |
In-hospital death | 0 (0.0%) | 2 (0.5%) | 0.984 |
Stroke | 0 (0.0%) | 1 (0.2%) | 0.551 |
Tamponade | 0 (0.0%) | 2 (0.5%) | 0.984 |
Pulmonary edema | 0 (0.0%) | 1 (0.2%) | 0.551 |
Dissection of aorta | 0 (0.0%) | 1 (0.2%) | 0.551 |
Perforation of femoral artery | 0 (0.0%) | 2 (0.5%) | 0.984 |
Contrast-induced nephropathy | 9 (6.9%) | 12 (3.0%) | 0.044 |
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Kałużna-Oleksy, M.; Skorupski, W.J.; Grygier, M.; Araszkiewicz, A.; Skorupski, W.; Grajek, S.; Mitkowski, P.; Pyda, M.; Lesiak, M. A Personalized Approach to Percutaneous Coronary Interventions in the Left Main Coronary Artery—Is the Female Gender Associated with Worse Outcomes? J. Pers. Med. 2021, 11, 581. https://doi.org/10.3390/jpm11060581
Kałużna-Oleksy M, Skorupski WJ, Grygier M, Araszkiewicz A, Skorupski W, Grajek S, Mitkowski P, Pyda M, Lesiak M. A Personalized Approach to Percutaneous Coronary Interventions in the Left Main Coronary Artery—Is the Female Gender Associated with Worse Outcomes? Journal of Personalized Medicine. 2021; 11(6):581. https://doi.org/10.3390/jpm11060581
Chicago/Turabian StyleKałużna-Oleksy, Marta, Wojciech Jan Skorupski, Marek Grygier, Aleksander Araszkiewicz, Włodzimierz Skorupski, Stefan Grajek, Przemysław Mitkowski, Małgorzata Pyda, and Maciej Lesiak. 2021. "A Personalized Approach to Percutaneous Coronary Interventions in the Left Main Coronary Artery—Is the Female Gender Associated with Worse Outcomes?" Journal of Personalized Medicine 11, no. 6: 581. https://doi.org/10.3390/jpm11060581
APA StyleKałużna-Oleksy, M., Skorupski, W. J., Grygier, M., Araszkiewicz, A., Skorupski, W., Grajek, S., Mitkowski, P., Pyda, M., & Lesiak, M. (2021). A Personalized Approach to Percutaneous Coronary Interventions in the Left Main Coronary Artery—Is the Female Gender Associated with Worse Outcomes? Journal of Personalized Medicine, 11(6), 581. https://doi.org/10.3390/jpm11060581