title: Comparison of Characteristics and Complications in Men Versus Women Undergoing Chronic Total Occlusion Percutaneous Intervention.
abstract: Gender differences exist in clinical outcomes after routine percutaneous coronary intervention (PCI), but studies reporting such outcomes after chronic total occlusion (CTO) PCI are limited. We assessed the characteristics and outcomes of female patients undergoing CTO PCI. We retrospectively analyzed a dedicated national (United Kingdom) prospective CTO database from 2011 to 2015 for outcomes and characteristics of female patients undergoing CTO PCI (unmatched and propensity matched). Female patients constituted 20.5% (n = 260 of 1,271) of the unmatched cohort and 33.3% (n = 233 of 699) of the matched cohort and were more likely to be older (women aged >70 years, 48% in the unmatched and 45% in the matched cohort). An increased inhospital complication rate was observed in female patients (unmatched: 10% women vs 4.45% men, p = 0.0012, and matched 9.87% women vs 3.86% men, p = 0.0032). Coronary perforation, bleeding, and contrast-induced nephropathy were more frequently observed in female patients. Femoral access site with >6 French sheath was associated with an increased risk of bleeding. Presence of calcification in the CTO artery was associated with coronary perforation (grade III) in female patients in the matched cohort (p = 0.007). Female patients undergoing CTO PCI were older and experienced increased of inhospital complications. Increased awareness of these complications could influence the selection of access site and sheath size, the need for prehydration, judicious choice of balloon size, collateral selection, and wire placement in female patients undergoing CTO PCI.
authors.affiliation: Department of Cardiology, Peter Munk Cardiac Centre, Toronto General Hospital, Toronto, Canada.
authors.forename: Vinoda
authors.initials: V
authors.lastname: Sharma
authors.affiliation: Department of Cardiology, Royal Melbourne Hospital, Melbourne, Australia.
authors.forename: William
authors.initials: W
authors.lastname: Wilson
authors.affiliation: Department of Cardiology, Trent Cardiac Centre, Nottingham City Hospital, Nottingham, United Kingdom.
authors.forename: William
authors.initials: W
authors.lastname: Smith
authors.affiliation: Department of Cardiology, Golden Jubilee National Hospital, Glasgow, United Kingdom.
authors.forename: Margaret
authors.initials: M
authors.lastname: McEntegart
authors.affiliation: Department of Cardiology, Golden Jubilee National Hospital, Glasgow, United Kingdom.
authors.forename: Keith
authors.initials: K
authors.lastname: Oldroyd
authors.affiliation: Department of Cardiology, Golden Jubilee National Hospital, Glasgow, United Kingdom.
authors.forename: Novalia
authors.initials: N
authors.lastname: Sidik
authors.affiliation: Department of Cardiology, Freeman Hospital, Newcastle-upon-Tyne, United Kingdom.
authors.forename: Alan
authors.initials: A
authors.lastname: Bagnall
authors.affiliation: Department of Cardiology, Freeman Hospital, Newcastle-upon-Tyne, United Kingdom.
authors.forename: Mohaned
authors.initials: M
authors.lastname: Egred
authors.affiliation: Department of Cardiology, Ninewells Hospital, Dundee, United Kingdom.
authors.forename: John
authors.initials: J
authors.lastname: Irving
authors.affiliation: Department of Cardiology, University Hospitals Bristol, Bristol, United Kingdom.
authors.forename: Julian
authors.initials: J
authors.lastname: Strange
authors.affiliation: Department of Cardiology, University Hospitals Bristol, Bristol, United Kingdom.
authors.forename: Thomas
authors.initials: T
authors.lastname: Johnson
authors.affiliation: Department of Cardiology, Belfast City Hospital, Belfast, United Kingdom.
authors.forename: Simon
authors.initials: S
authors.lastname: Walsh
authors.affiliation: Department of Cardiology, Belfast City Hospital, Belfast, United Kingdom.
authors.forename: Colm
authors.initials: C
authors.lastname: Hanratty
authors.affiliation: Department of Cardiology, Forth Valley Royal Hospital, Larbert, United Kingdom. Electronic address: James.spratt@nhs.net.
authors.forename: James
authors.initials: J
authors.lastname: Spratt
mesh_terms: D058186:Acute Kidney Injury / Q000139:chemically induced / Q000453:epidemiology; D017677:Age Distribution; D000368:Aged; D002908:Chronic Disease; D015897:Comorbidity; D003287:Contrast Media / Q000009:adverse effects; D054059:Coronary Occlusion / Q000453:epidemiology / Q000601:surgery*; D003331:Coronary Vessels / Q000293:injuries; D016208:Databases, Factual; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D062645:Percutaneous Coronary Intervention; D011183:Postoperative Complications / Q000453:epidemiology*; D019106:Postoperative Hemorrhage / Q000453:epidemiology; D012189:Retrospective Studies; D017678:Sex Distribution; D012737:Sex Factors; D006113:United Kingdom / Q000453:epidemiology; D061205:Vascular Calcification / Q000453:epidemiology*; D057772:Vascular System Injuries / Q000453:epidemiology
chemical_list: D003287:Contrast Media