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Gender-Based Analysis: Clinical Outcome of Coronary Revascularization
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Gender-Based Analysis: Clinical Outcome of Coronary Revascularization

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Cardiovascular Medicine".

Deadline for manuscript submissions: closed (30 March 2022) | Viewed by 14984

Special Issue Editor

Dr. Daniela Trabattoni

E-Mail Website
Guest Editor
Director, Invasive Cardiology Unit 3Director, Women Heart CenterCentro Cardiologico Monzino, IRCCS, Milan, Italy
Interests: coronary artery disease; interventional cardiology; percutaneous coronary interventions and coronary stents; acute myocardial infarction; women heart disease

Special Issue Information

Dear Colleagues,

Cardiovascular disease (CVD) is the leading cause of mortality in women. There are well-described differences between men and women in epidemiology, pathophysiology, clinical presentation, and outcome of cardiac disease. Although risk factors responsible for CVD are between gender, their relative importance differs. The more atypical presentation of women makes the diagnostic evaluation of symptomatic women challenging to improve the precision of ischemic heart disease recognition. Women have more angina yet less obstructive coronary artery disease; therefore, women more often present with myocardial infarction with normal coronary arteries (MINOCA) and Takotsubo cardiomyopathy. In comparison with men, pPCI for STEMI treatment in women is associated with a higher mortality that is not caused by the female gender per se but can be related to a disadvantageous risk profile and delayed presentation time, leading to a postponed treatment. Research efforts over the last decade have led to a comprehensive analysis of the more atypical symptom presentation in women, making the diagnostic evaluation challenging to improve the precision of ischemic heart disease recognition. The present Special Issue aims to overview the current knowledge, latest evidence, and unresolved issues in the field of percutaneous coronary interventions in women.

Therefore, I welcome the submission of innovative original research papers and in-depth review articles dealing with percutaneous coronary interventions in women and men, including evaluation of technical characteristics and third-generation stents, long-term outcomes according to clinical presentation, and physiologic assessment of microcirculatory dysfunction.

Dr. Daniela Trabattoni
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Journal of Clinical Medicine is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • coronary disease in women
  • MINOCA/INOCA
  • microcirculatory dysfunction
  • PCI
  • second-generation DES
  • clinical outcomes
  • bleeding
  • short DAPT
  • vascular complications after PCI
  • radial access

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Published Papers (3 papers)

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Research

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12 pages, 1601 KiB  
Article
Procedural Outcomes in Patients Treated with Percutaneous Coronary Interventions within Chronic Total Occlusions Stratified by Gender
by Zbigniew Siudak, Leszek Bryniarski, Krzysztof Piotr Malinowski, Wojciech Wańha, Wojciech Wojakowski, Sławomir Surowiec, Robert Balan, Sławomir Januszek, Artur Pawlik, Natalia Siwiec, Krzysztof Bryniarski, Andrzej Surdacki, Jacek Legutko, Krzysztof Bartuś, Stanisław Bartuś and Rafał Januszek
J. Clin. Med. 2022, 11(5), 1419; https://doi.org/10.3390/jcm11051419 - 4 Mar 2022
Cited by 3 | Viewed by 1949
Abstract
It has been demonstrated that gender differences are related to different procedural and long-term clinical outcomes among a general patient population treated using percutaneous coronary interventions (PCI). The objective of our analysis was to conduct assessment regarding the relationship between gender and procedural [...] Read more.
It has been demonstrated that gender differences are related to different procedural and long-term clinical outcomes among a general patient population treated using percutaneous coronary interventions (PCI). The objective of our analysis was to conduct assessment regarding the relationship between gender and procedural outcomes in patients treated for PCI regarding chronic total occlusions (CTO), based on a large, real-life registry. Data used to conduct the following analysis was derived from the national registry of percutaneous coronary interventions (ORPKI), upheld in co-operation with the Association of Cardiovascular Interventions (AISN) of the Polish Cardiac Society. The study involved data procured from the registry within the period from January 2014 to December 2020. All subsequent CTO procedures recorded in the registry during that period were included in the analysis. We assessed the correlation between gender and the overall rate of periprocedural complications, procedure-related mortality, and success evaluated as TIMI flow grade 3 after the procedure by univariate and multivariable modeling. At the time of conducting our investigation, there were 162 existing and active CathLabs, at which 747,033 PCI procedures were carried out during the observational period. Of those, 14,903 (1.99%) were CTO-PCI procedures, and 3726 were women (25%). The percentage share between genders did not experience any significant changes during the consecutive years observed in the current analysis. Overall periprocedural complication rate was greater among women than men (3.45% vs. 2.31%, p = 0.02). A comparable relationship was noted for procedural mortality (0.7% vs. 0.2%, p = 0.006), while procedural success occurred more often in the case of women (69.3% vs. 65.2%, p < 0.001). Women were found to be more frequently affected by periprocedural complications (OR = 1.553; 95%CI: 1.212–1.99, p < 0.001) as well as procedural success (OR = 1.294; 95%CI: 1.151–1.454, p < 0.001), evaluated using multivariable models. Based on the current analysis performed on all-comer patients treated using PCI in CTO, women are affected by more frequent procedural complication occurrence as well as greater procedural success compared to men. Full article
(This article belongs to the Special Issue Gender-Based Analysis: Clinical Outcome of Coronary Revascularization)
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10 pages, 846 KiB  
Article
Sex Differences in the Clinical Features and Outcomes of Patients with Acute Coronary Syndrome Treated with Two Generations (Absorb and Magmaris) of Bioresorbable Vascular Scaffolds
by Adrian Włodarczak, Piotr Rola, Marek Szudrowicz, Magdalena Łanocha, Mateusz Barycki, Jan Jakub Kulczycki, Alicja Gosiewska, Karol Turkiewicz, Maciej Lesiak and Adrian Doroszko
J. Clin. Med. 2021, 10(17), 3768; https://doi.org/10.3390/jcm10173768 - 24 Aug 2021
Cited by 7 | Viewed by 1660
Abstract
Background: Despite the developments in percutaneous coronary interventions (PCI), women are still more likely than men to have unfavorable outcomes after PCI performed in Acute Coronary Syndrome (ACS). The mechanisms of this phenomena are not fully understood. Potential benefits of bioresorbable scaffolds (BRS) [...] Read more.
Background: Despite the developments in percutaneous coronary interventions (PCI), women are still more likely than men to have unfavorable outcomes after PCI performed in Acute Coronary Syndrome (ACS). The mechanisms of this phenomena are not fully understood. Potential benefits of bioresorbable scaffolds (BRS) may be particularly expressed in the female population. Nevertheless, the data available currently are inconsistent and limited. This study evaluated the gender-related differences in the short-term clinical outcomes in ACS patients treated with implantation of two generations of BRS (first generation, Absorb; second generation, Magmaris). Methods: The study was divided into two arms. To the first one, we qualified 160 patients with ACS treated with PCI who received 210 Absorb scaffolds. The second arm was composed of 193 patients with ACS who underwent PCI with Magmaris implantation. Results: There were no significant sex-related differences in primary endpoints (cardiovascular-death, myocardial infarction, in-stent thrombosis) or principal secondary endpoints (of target-lesion failure, scaffold restenosis, death from any reason, other cardiovascular events) in either generation of BRS in a 1-year follow-up. Conclusions: Both genders tended to have a similar outcome in routine clinical practice following BRS implantation due to ACS. The magnesium bioresorbable scaffold (Magmaris) early outcome seemed to be more favorable in comparison to the Absorb scaffold. Full article
(This article belongs to the Special Issue Gender-Based Analysis: Clinical Outcome of Coronary Revascularization)
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Review

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12 pages, 885 KiB  
Review
Spontaneous Coronary Artery Dissections: A Systematic Review
by Giovanni Teruzzi, Giulia Santagostino Baldi, Sebastiano Gili, Gianluca Guarnieri, Piero Montorsi and Daniela Trabattoni
J. Clin. Med. 2021, 10(24), 5925; https://doi.org/10.3390/jcm10245925 - 17 Dec 2021
Cited by 10 | Viewed by 10720
Abstract
Myocardial infarction with nonobstructive coronary artery disease due to spontaneous coronary artery dissection (SCAD) accounts for 5–8% of acute coronary syndrome (ACS) presentations. The demographic characteristics, risk factors, and management of patients with SCAD differ from those with atherosclerotic disease. The objective of [...] Read more.
Myocardial infarction with nonobstructive coronary artery disease due to spontaneous coronary artery dissection (SCAD) accounts for 5–8% of acute coronary syndrome (ACS) presentations. The demographic characteristics, risk factors, and management of patients with SCAD differ from those with atherosclerotic disease. The objective of this review is to provide a contemporary understanding of the epidemiology, pathophysiology, clinical presentation, and management of SCAD. Full article
(This article belongs to the Special Issue Gender-Based Analysis: Clinical Outcome of Coronary Revascularization)
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