Impact of Gender on Percutaneous Revascularization of Unprotected Left Main Coronary Artery: Clinical Outcomes in 4,602 Patients.

Alam, Mahboob

Impact of Gender on Percutaneous Revascularization of Unprotected Left Main Coronary Artery: Clinical Outcomes in 4,602 Patients.

Wednesday, May 22, 2019

Belmont Ballroom 2-3 (The Cosmopolitan of Las Vegas)

Mahboob Alam, M.D., FSCAI , Baylor College of Medicine, Sugarland, TX

Mahin R Khan, MD , McLaren Flint - Michigan State University, Flint, MI

Waqas Ahmad, M.B, B.S. , Nishtar Medical College, Multan, Pakistan

Ihab Hamzeh, MD, FACC , Baylor College of Medicine, Houston, TX

Salim S Virani, MD , Baylor College of Medicine, Houston, TX

Yochai Birnbaum, MD, FACC, FAHA , Baylor College of Medicine, Houston, TX

Nasser M Lakkis, M.D., FACC, FSCAI , Baylor College of Medicine, Houston, TX

Background:
The impact of gender on outcomes of percutaneous coronary intervention (PCI) in patients with unprotected left main coronary artery (ULMCA) remains unclear. We sought to define the impact of gender on clinical outcomes in patients undergoing PCI for ULMCA disease by means of a meta-analysis of available literature.

Methods:
A time unlimited literature search using PubMed, EMBASE and Cochrane databases identified 4 studies (2 randomized, 2 prospective registries) reported gender stratified outcomes of PCI for ULMCA disease. Primary outcome of interest was MACCE and secondary outcomes included all-cause mortality, non-fatal MI, non-fatal stroke and repeat revascularization. For meta-analysis, effect size was estimated with Odds Ratio(OR) and 95% confidence intervals using a random-effects model.

Results:
A total of 4,602 patients were included in this meta-analysis. Baseline and demographic variables were comparable. There was a trend towards lower MACCE in men (OR 1.20, CI 1.00- 1.44). All-cause mortality (OR 1.17, CI 0.86- 1.58) and stroke (OR 1.64, 0.79- 3.39) were comparable between the two groups. Women experienced higher rates of non-fatal MI (OR 1.60, 1.12- 2.29) and repeat revascularization (OR 1.35, CI 1.10- 1.67) as compared to men.

Conclusions:
In patients with ULMCA disease, women suffered from higher rates of MI and repeat revascularization. This was also evident with higher MACE rates in women when compared to men. There was no difference in terms of all-cause mortality between men and women.