Role of target vessel size and body surface area on outcomes after percutaneous coronary interventions in women.
BACKGROUND
Women have higher mortality rates than men after coronary angioplasty. Differences in target vessel size may partially account for these differences. We set out to explore the effects of sex, body surface area (BSA), and target coronary vessel size on clinical outcomes after angioplasty.


METHODS
Data from 5 interventional trials and 1 registry were pooled for analysis (n = 3982).


RESULTS
Compared with men, women undergoing angioplasty were older, had lower weights and BSA, more coronary risk factors, and slightly smaller target coronary vessel size (as assessed by reference vessel diameter). The correlation between target vessel size and BSA was poor (r = 0.13). At 6 months, women had higher mortality rates (1.7% vs 0.8%, P =.03) but similar rates of myocardial infarction and repeat revascularization. On univariate analysis, advanced age, smaller BSA, and female sex were associated with increased mortality, but target vessel size was not. Advanced age was the only significant multivariate predictor of mortality. Target vessel size and diabetes were independent predictors of repeat revascularization.


CONCLUSIONS
Women have higher unadjusted 6-month mortality rates after angioplasty, owing largely to their more advanced age at the time of intervention. Smaller target vessel size is associated with increased risk of restenosis and repeat revascularization; however, it does not appear to be a predictor for downstream mortality. As such, the fact that women have smaller vessels does not account for their higher 6-month mortality after coronary angioplasty.
St Michael's Hospital, Toronto, Ontario, Canada. cantorw@smh.toronto.on.ca
Warren J
WJ
Cantor
Julie M
JM
Miller
Anne S
AS
Hellkamp
Judith M
JM
Kramer
Eric D
ED
Peterson
Vic
V
Hasselblad
James P
JP
Zidar
L Kristin
LK
Newby
E Magnus
EM
Ohman
D000368:Aged; D015906:Angioplasty, Balloon, Coronary / Q000401:mortality*; D001830:Body Surface Area; D017023:Coronary Angiography; D003327:Coronary Disease / Q000503:physiopathology* / Q000628:therapy*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012307:Risk Factors; D012737:Sex Factors; D015996:Survival Rate; D016896:Treatment Outcome