title: Gender-Based Differences in Outcomes After Orbital Atherectomy for the Treatment of De Novo Severely Calcified Coronary Lesions.
abstract: OBJECTIVE
  We evaluated the relationship between gender and angiographic and clinical outcomes in patients with severely calcified lesions who underwent orbital atherectomy.
  
  
  BACKGROUND
  Female gender is associated with increased risk of adverse clinical events after percutaneous coronary intervention (PCI). Severe coronary artery calcification increases the complexity of PCI and increases the risk of adverse cardiac events. Orbital atherectomy is effective in plaque modification, which facilitates stent delivery and expansion. Whether gender differences exist after orbital atherectomy is unclear.
  
  
  METHODS
  Our analysis retrospectively analyzed 458 consecutive real-world patients (314 males and 144 females) from three centers who underwent orbital atherectomy. The primary endpoint was the major adverse cardiac and cerebrovascular event (MACCE) rate, defined as the composite of death, myocardial infarction (MI), target-vessel revascularization (TVR), and stroke, at 30 days.
  
  
  RESULTS
  The primary endpoint of MACCE was low and similar in females and males (0.7% vs 2.9%; P=.14). The individual endpoints of death (0.7% vs 1.6%; P=.43), MI (0.7% vs 1.3%; P=.58), TVR (0% vs 0%; P>.99), and stroke (0% vs 0.3%; P=.50) were low in both groups and did not differ. Angiographic complications were low: perforation (0.8% vs 0.7%; P>.90), dissection (0.8% vs 1.1%; P=.80), and no-reflow (0.8% vs 0.7%; P>.90).
  
  
  CONCLUSIONS
  Plaque modification with orbital atherectomy was safe and provided similar angiographic and clinical outcomes between females and males. Randomized trials with longer-term follow-up are needed to support our results.
authors: UCLA Medical Center, 100 Medical Plaza, Suite 630, Los Angeles, CA 90095 USA. mslee@mednet.ucla.edu.
authors: Michael S
authors: MS
authors: Lee
authors: Evan
authors: E
authors: Shlofmitz
authors: Pejman
authors: P
authors: Mansourian
authors: Sanjum
authors: S
authors: Sethi
authors: Richard A
authors: RA
authors: Shlofmitz
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D017225:Atherectomy, Coronary / Q000009:adverse effects / Q000379:methods; D017023:Coronary Angiography / Q000379:methods; D003324:Coronary Artery Disease / Q000175:diagnosis / Q000401:mortality / Q000601:surgery; D003331:Coronary Vessels / Q000000981:diagnostic imaging / Q000473:pathology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009026:Mortality; D010043:Outcome and Process Assessment, Health Care; D058226:Plaque, Atherosclerotic / Q000000981:diagnostic imaging / Q000601:surgery; D011183:Postoperative Complications / Q000175:diagnosis*; D012189:Retrospective Studies; D018570:Risk Assessment; D012720:Severity of Illness Index; D012737:Sex Factors; D020521:Stroke / Q000175:diagnosis / Q000209:etiology; D014481:United States / Q000453:epidemiology; D061205:Vascular Calcification / Q000000981:diagnostic imaging; D057772:Vascular System Injuries / Q000175:diagnosis / Q000209:etiology