Gender disparities in outcomes following percutaneous coronary intervention for unprotected left main coronary artery disease

Introduction

Understanding the nuanced disparities in clinical outcomes between male and female patients undergoing percutaneous coronary intervention (PCI) for unprotected left main coronary artery disease (CAD) is pivotal in refining patient care and treatment protocols.

Objective

To determine the sex-specific outcomes in left main PCI.

Method

We analysed data from 213 patients (48 females; 165 males) with unprotected left main CAD who underwent PCI between January 2012 and January 2023 in our catheterization lab. The primary endpoint was a composite of all-cause mortality, myocardial infarction, or stroke.

Results

Median follow-up duration was 2.16 years. Although women tended to be older and had higher rates of diabetes mellitus and hypertension, these distinctions were not statistically significant. Men more frequently presented with left main bifurcation lesions and extensive CAD. Baseline findings revealed that wall motion abnormalities were more prevalent in men compared to women (68.3% vs. 50%, respectively; p = 0.020). Notably, the presence of wall motion abnormalities emerged as a significant predictor of adverse outcomes, including total mortality (19.2% vs. 5.4%; p = 0.007) and cardiac death (16.2% vs. 2.7%; p = 0.003). However, the primary endpoint did not exhibit a statistically significant difference between genders (20.8% vs. 24.8%, respectively; p = 0.569). Similarly, the requirement for target lesion revascularization was comparable in both groups (7.9% vs. 12.5%, respectively; p = 0.566).

Conclusion

Despite variations in clinical and lesion characteristics, female and male patients demonstrated similar long-term outcomes post-PCI for left main CAD.