Sex differences and their impact on clinical outcome after percutaneous or surgical revascularisation: a report from the Arterial Revascularisation Therapies Study (ARTS).
OBJECTIVE
To determine whether women have an unfavorable outcome after coronary interventions compared with men, we evaluated patients undergoing revascularisation within the Arterial Revascularisation Therapies Study (ARTS).


RESULTS
We evaluated 1205 patients (23% women) with multivessel disease randomised to percutaneous or surgical coronary revascularisation. The in-hospital results, and clinical outcome at five years were evaluated. Women were older, with a higher prevalence of hypertension, hypercholesterolaemia, family history for coronary artery disease (all p<0.001), diabetes mellitus (p=0.05) and stable angina (p<0.05) than men, but had a lower incidence of history of myocardial infarction or smoking (both p<0.001). More major bleeding complications, even after adjusting for baseline clinical characteristics (OR 29.4, 95% CI: 5.3-500, p<0.005) were observed in women following percutaneous coronary intervention. During clinical follow-up freedom from major adverse cardiac and cerebrovascular events was similar in men and women, regardless of treatment strategy. Men assigned to bypass surgery had a better quality of life, but women reported more frequently angina.


CONCLUSIONS
The clinical outcome of women with multivessel disease undergoing coronary revascularisation was similar to that in men. However, women presented more bleeding complications before hospital discharge, and had less favourable assessment in specific domain of daily life at follow-up.
Voudris
Vassilis
V
Onassis Cardiac Surgery Center, Athens, Greece.
Ong
Andrew T L
AT
Serruys
Patrick W
PW
Sianos
George
G
Stavrides
George
G
Lindeboom
Wietze
W
Cokkinos
Dennis V
DV