Outcomes of guideline-recommended percutaneous coronary intervention in women with obstructive coronary artery disease

J. Am. Coll. Cardiol; 84 (18 Suppl. B), 2024
Ano de publicação: 2024

BACKGROUND Previous studies have shown that women with coto nary artery disease (CAD) are less likely to undergo angiography and have less favorable clinical outcomes after percutaneous coronary intervention (PCI). METHODS This observational longitudinal cohort study with pro spective clinical follow up consecutively included all female patients >18 years of age admitted from January 2019 to December 2020. Ра- tients had 1 or more lesions in the native coronary artery or saphenous vein graft suitable for PCL. RESULTS 1,146 female patients (average age 65 years, range 58-96 years) underwent guideline-recommended PCI with drug-eluting stents. Traditional tisk factors were highly represented (hypertension in 88%, dyslipidemia in 85%, diabetes in 47.5%), 32% had previous myocardial infaction (MD, and 69% were being admitted because of acute coronary syndrome (ACS). Radial access was used in 59% of patients; 1,516 vessels were treated with 1,725 stents implanted (1.5 stents/patient). Unprotected left main was treated in 3.6% of patients. PCI was successful in 97.7%, in-hospital death occurred in 1.2%, periprocedural MI in 3.6%, and transient ischemic attack in 0.4% After adjusted multivariate analysis, age (OR: 1.02; 95% CI 1.00-1.04; P-0.012), chronic kidney disease (OR: 2.01; 95% 0.002), and at least 1 procedural failure C: 1.28-3.

11:

P- ein 1 of the treated vessels (OR 1.11, 95% Cl 2.80-18.7; P < 0.001) were predictors of in-hospital complications. The average follow-up time was 576.2 days in 1,047 patients, and the median survival time was 1,249 days. All-cause mortality occurred in 5.3%, cardiac death in 3.5%, recurrent ACS in 8% of the patients, and additional revascularization procedures (related to ACS, restenosis, and CAD progression) in 5.5% of cases. At the end of the follow-up, 86% of patients were free from major cardiac and cerebrovascular events (MACCE). The predictors for MACCE during follow-up were hospital admission for ACS for the index PCI (OR: 1.58; 95% Ch 106-2.

35:

P 0.021) and the presence of major cardiac and cerebrovascular events during hospitalization (OR: 6.

66:

95% CL 2.42 18.

3:

P<0.001). CONCLUSIONS In this pioneering study involving female patients treated with PCI according to the guideline-recommended therapies and followed for a period of approximately 2 years, we obtained encouraging in-hospital and midterm results.

Mais relacionados