Men and women benefit equally from chronic total coronary occlusion PCI
Men and women enjoy equal survival benefits from chronic total coronary occlusion (CTO) percutaneous coronary intervention (PCI), reports a new study.
Researchers enrolled 1,343 patients undergoing CTO PCI and compared procedural and clinical outcome variables according to sex. Men outnumbered women in the cohort (85.6 percent vs 14.4 percent), but women tended to be significantly older (mean age, 68.5±9.9 vs 62.3±10.8 years; p<0.001). Diabetes mellitus and hypertension were also more frequent in women.
Success rates were statistically comparable between men and women (74.0 percent vs 77.3 percent; p=0.323). This was further confirmed through multivariate analysis, which found that sex was not a significant factor associated with procedural success (odds ratio [OR], 1.140; 95 percent CI, 0.773–1.681; p=0.508).
Procedural success, in comparison, was a stronger predictor of outcome. In both men and women, successful CTO PCI was significantly associated with lower risks of all-cause death, cardiac death and major adverse cardiovascular events (MACEs). Kaplan-Meier analysis verified that men and women who had successful revascularization had lower mortality rates.
Subsequent multivariate analysis identified age (p<0.001), acute coronary syndrome (p=0.005) and cardiac arrest (p<0.001) at presentation, insulin-dependent diabetes (p<0.001) and failed CTO PCI (p=0.02) as independent predictors of mortality.
In comparison, factors predictive of MACE included nonsilent ischaemia (p=0.03), insulin-dependent diabetes (p<0.001), current smoking (p=0.008), calcified lesions (p=0.001) and cardiac arrest at presentation (p<0.001).
Trends were similar and sex remained insignificant when analyses were restricted to participants with successful CTO PCI.