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Catheter Cardiovasc Interv. 2016 May;87(6):1063-70. doi: 10.1002/ccd.26330. Epub 2015 Nov 25.

Gender differences in the prevalence and treatment of coronary chronic total occlusions.

Author information

1
Division of Cardiology, Schulich Heart Program, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada.
2
Department of Cardiology, Sheba Medical Center, Tel Aviv University, Tel Aviv, Israel.
3
Division of Cardiology, Libin Cardiovascular Institute of Alberta, Calgary, Alberta, Canada.
4
Division of Cardiology, St. Michael's Hospital, Toronto, Ontario, Canada.
5
Department of Medicine, University of Toronto, Division of Cardiology, Toronto, Ontario, Canada.
6
Management and Evaluation (IHPME), University of Toronto, Institute of Health Policy, Toronto, Ontario, Canada.
7
Institute for Clinical Evaluative Sciences (ICES), Toronto, Ontario, Canada.

Abstract

BACKGROUND:

Gender differences exist in the presentation and outcomes of patients with coronary artery disease (CAD). Our study objective was to compare gender differences in prevalence, co-morbidities, and revascularization treatment in CAD patients with chronic total occlusions (CTOs).

METHODS:

A retrospective analysis using the Canadian Multicenter CTO Registry, which included 1,690 consecutive CTO patients identified at coronary angiography and a control group of 7,682 non-CTO patients.

RESULTS:

The prevalence of women in the CTO group was significantly lower compared to the control group (19% vs. 30%, P < 0.001). Within the overall CTO group, women were significantly older than men (70 ± 12 vs. 66 ± 11 years, P < 0.001) with more comorbidities, including hypertension and heart failure. Rates of PCI in the CTO group were similar between gender (10%), however, women with CTO were treated significantly less by CABG compared to men (19% vs. 27%, P = 0.003). Moreover, compared to male patients, significantly fewer women undergoing CABG had revascularization of the CTO artery (84% vs. 93%, P = 0.03). Multivariable analysis indicated that female gender (along with age, chronic renal failure, prior MI and cerebro-vascular disease) were independent predictors for not receiving CABG treatment for CTO.

CONCLUSIONS:

Female gender differences exist in CTO patients with both lower prevalence of CTOs at angiography and lower revascularization rates of CTOs by CABG. © 2015 Wiley Periodicals, Inc.

KEYWORDS:

coronary artery disease; gender; outcomes/studies; percutaneous coronary intervention

PMID:
26602868
DOI:
10.1002/ccd.26330
[Indexed for MEDLINE]

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