{"title":"Outcomes of Guideline-Recommended Percutaneous Coronary Intervention in Women with Obstructive Coronary Artery Disease: A Longitudinal Cohort Study.","authors":"Tacianne Rolemberg Braga Delamain, José Henrique Herrmann Delamain, Sergio Luiz Navarro Braga, Ricardo Costa, Dimytri Alexandre Alvim de Siqueira, Fausto Feres, Marinella Patrizia Centemero","doi":"10.36660/abc.20240249","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Previous studies have shown that women with coronary artery disease (CAD) are less likely to undergo angiography and have less favorable outcomes after percutaneous coronary intervention (PCI).</p><p><strong>Objectives: </strong>Assess the outcomes of women with acute coronary syndrome (ACS) and stable CAD (lesion>50%) treated with contemporary PCI using DES.</p><p><strong>Methods: </strong>Observational, longitudinal cohort study with prospective follow-up included all female patients ≥ 18 years admitted at a tertiary public cardiovascular center in Brazil from January 2019 to December 2020. The level of significance adopted in the statistical analysis was 5%.</p><p><strong>Results: </strong>1146 women (average age 65 years) underwent guideline-recommended PCI. Risk factors were frequent (hypertension: 88%, dyslipidemia: 85%, diabetes: 47.5%), and 69% were admitted due to ACS. Radial access was used in 59% of patients; 1516 vessels were treated with 1725 stents implanted (1.5 stents/patient). PCI was successful in 97.7%, in-hospital death occurred in 1.2%, peri-procedural MI in 3.6%, and TIA in 0.4%. Predictors of in-hospital major adverse cardiac and cerebrovascular events (MACCE): previous stroke (OR: 2.97; CI: 1.06-7.15; p= 0.023), CKD (OR: 3.11; CI: 1.49-6.20; p= 0.002), and at least one procedural failure during PCI (OR: 10.2; CI: 1.17-5.9; p<0.001). The average follow-up was 576.2 days in 1047 patients. All-cause mortality occurred in 5.3%, cardiac death in 3.5%, recurrent ACS in 8%, and additional revascularization procedures in 5.5%. The predictors for MACCE during FU were hospital admission for ACS for the index PCI (OR: 1.58; HR: 1.06-2.35; p=0.023) and the presence of MACCE during hospitalization (OR: 6.66; HR: 2.42- 18.3; p< 0.001).</p><p><strong>Conclusion: </strong>In this pioneering study involving 1146 patients treated by contemporary PCI and followed for almost 2 years, we obtained very encouraging in-hospital and mid-term results.</p>","PeriodicalId":93887,"journal":{"name":"Arquivos brasileiros de cardiologia","volume":"122 1","pages":"e20240249"},"PeriodicalIF":0.0000,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11805569/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Arquivos brasileiros de cardiologia","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.36660/abc.20240249","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
Outcomes of Guideline-Recommended Percutaneous Coronary Intervention in Women with Obstructive Coronary Artery Disease: A Longitudinal Cohort Study.
Background: Previous studies have shown that women with coronary artery disease (CAD) are less likely to undergo angiography and have less favorable outcomes after percutaneous coronary intervention (PCI).
Objectives: Assess the outcomes of women with acute coronary syndrome (ACS) and stable CAD (lesion>50%) treated with contemporary PCI using DES.
Methods: Observational, longitudinal cohort study with prospective follow-up included all female patients ≥ 18 years admitted at a tertiary public cardiovascular center in Brazil from January 2019 to December 2020. The level of significance adopted in the statistical analysis was 5%.
Results: 1146 women (average age 65 years) underwent guideline-recommended PCI. Risk factors were frequent (hypertension: 88%, dyslipidemia: 85%, diabetes: 47.5%), and 69% were admitted due to ACS. Radial access was used in 59% of patients; 1516 vessels were treated with 1725 stents implanted (1.5 stents/patient). PCI was successful in 97.7%, in-hospital death occurred in 1.2%, peri-procedural MI in 3.6%, and TIA in 0.4%. Predictors of in-hospital major adverse cardiac and cerebrovascular events (MACCE): previous stroke (OR: 2.97; CI: 1.06-7.15; p= 0.023), CKD (OR: 3.11; CI: 1.49-6.20; p= 0.002), and at least one procedural failure during PCI (OR: 10.2; CI: 1.17-5.9; p<0.001). The average follow-up was 576.2 days in 1047 patients. All-cause mortality occurred in 5.3%, cardiac death in 3.5%, recurrent ACS in 8%, and additional revascularization procedures in 5.5%. The predictors for MACCE during FU were hospital admission for ACS for the index PCI (OR: 1.58; HR: 1.06-2.35; p=0.023) and the presence of MACCE during hospitalization (OR: 6.66; HR: 2.42- 18.3; p< 0.001).
Conclusion: In this pioneering study involving 1146 patients treated by contemporary PCI and followed for almost 2 years, we obtained very encouraging in-hospital and mid-term results.
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