Guelker J E, Bansemir L, Ott R, Kuhr K, Koektuerk B, Turan R G, Klues H G, Bufe A
Heart Centre Niederrhein, Department of Cardiology, Helios Clinic Krefeld, Krefeld, Germany.
Institute for Heart and Circulation Research, University Cologne, Cologne, Germany.
Neth Heart J. 2017 May;25(5):304-311. doi: 10.1007/s12471-017-0966-3.
Percutaneous coronary intervention (PCI) of total chronic coronary occlusion (CTO) still remains a major challenge. Insignificant data are reported in the literature about gender differences in CTO-PCI in the era of new drug-eluting stents. In this study we analysed the impact of gender on procedural characteristics, complications and acute results.
Between 2010-2015 we included 780 consecutive patients. They underwent PCI for at least one CTO. Antegrade and retrograde CTO techniques were applied.
Patients undergoing CTO-PCI were mainly men (84%). Male patients were younger (66.9 years ±10.6 vs. 61.1 years ±10.4; p < 0.001), more often smokers, but less frequently had a history of coronary artery disease (24.4% vs. 32.7%; p = 0.085) compared with female patients. Female patients more often had diabetes mellitus (29.6% vs. 26.7%; p = 0.55) and hypertension (82.7% vs. 80.7%; p = 0.55). There were no differences with respect to the amount of contrast fluid, fluoroscopy time and examination time as well as to the length of the stent or the number of the stents. The stent diameter was slightly smaller in women, which was not surprising because the lumen calibre tends to be smaller in women than in men (3.0 mm (2.5-3) vs. 3.0 mm (3-3.5); p < 0.001). The success rates were 81.0% in women and 80.1% in men. There was no significant interaction between gender and procedural success and complication rates.
Our retrospective study suggests that women and men have a comparable success rate at a low complication rate after recanalisation of CTO.
完全慢性冠状动脉闭塞（CTO）的经皮冠状动脉介入治疗（PCI）仍然是一项重大挑战。在新药洗脱支架时代，关于CTO-PCI中性别差异的文献报道数据较少。在本研究中，我们分析了性别对手术特征、并发症和急性结果的影响。
2010年至2015年期间，我们纳入了780例连续患者。他们因至少一处CTO接受了PCI治疗。应用了正向和逆向CTO技术。
接受CTO-PCI治疗的患者主要为男性（84%）。与女性患者相比，男性患者更年轻（66.9岁±10.6岁对61.1岁±10.4岁；p<0.001），吸烟更频繁，但冠心病病史较少（24.4%对32.7%；p=0.085）。女性患者糖尿病（29.6%对26.7%；p=0.55）和高血压（82.7%对80.7%；p=0.55）更为常见。在造影剂用量、透视时间和检查时间以及支架长度或支架数量方面没有差异。女性患者的支架直径略小，这并不奇怪，因为女性的管腔内径往往比男性小（3.0mm（2.5-3）对3.0mm（3-3.5）；p<0.001）。女性的成功率为81.0%，男性为80.1%。性别与手术成功率和并发症发生率之间没有显著的相互作用。
我们的回顾性研究表明，CTO再通后，女性和男性的成功率相当，并发症发生率较低。
