Department of Internal Medicine, Creighton University, Omaha, Nebraska, USA.
Department of Internal Medicine, Division of Cardiology, MercyOne Medical Center, Des Moines, Iowa, USA.
Catheter Cardiovasc Interv. 2022 Feb;99(2):254-262. doi: 10.1002/ccd.30017. Epub 2021 Nov 12.
Women are underrepresented in chronic total occlusion (CTO) trials and little is known about sex differences in the outcomes of CTO percutaneous coronary intervention (PCI). This meta-analysis aims to compare the outcomes of CTO PCI in males and females.
A comprehensive search of PubMed, EMBASE, Cochrane, Web of Science, and Google Scholar was performed for studies comparing outcomes of CTO PCI in females versus males from inception to January 26, 2021. The current statistical analysis was performed using STATA version 15.1 software (Stata Corporation, TX); P < 0.05 indicated statistical significance.
Fourteen observational studies were included in the analysis with 75% males and 25% females. The mean age was 64.47 ± 10.5 years and 68.98 ± 9.5 years for males and females, respectively. The median follow-up duration was 2.4 years. Males had a higher Japanese-CTO (J-CTO) score compared with females (MD = -0.17; 95% CI: -0.25 to -0.10). Females had statistically higher success rates of CTO PCI (RR = 1.03; 95% CI: 1.01 to1.05), required less contrast volume (MD = -18.64: 95% CI: -30.89 to -6.39) and fluoroscopy time (MD = -9.12; 95% CI: -16.90 to -1.34) compared with males. There was no statistical difference in in-hospital (RR = 1.50; 95% CI: 0.73 to 3.09) or longer term (≥6 months) all-cause mortality (RR = 1.10; 95% CI: 0.86 to 1.42) between the two groups.
CTO PCI is feasible and safe in female patients with comparable outcomes in female versus male patients.
女性在慢性完全闭塞（CTO）试验中代表性不足，关于 CTO 经皮冠状动脉介入治疗（PCI）结局的性别差异知之甚少。本荟萃分析旨在比较男性和女性 CTO PCI 的结局。
从建库至 2021 年 1 月 26 日，全面检索 PubMed、EMBASE、Cochrane、Web of Science 和 Google Scholar 中比较女性与男性 CTO PCI 结局的研究。当前的统计分析使用 STATA 版本 15.1 软件（Stata Corporation，TX）进行；P<0.05 表示有统计学意义。
共纳入 14 项观察性研究，男性占 75%，女性占 25%。男性的平均年龄为 64.47±10.5 岁，女性为 68.98±9.5 岁。中位随访时间为 2.4 年。与女性相比，男性的日本 CTO（J-CTO）评分更高（MD=-0.17；95%CI：-0.25 至-0.10）。女性 CTO PCI 的成功率更高（RR=1.03；95%CI：1.01 至 1.05），需要的造影剂体积更少（MD=-18.64；95%CI：-30.89 至-6.39）和透视时间更少（MD=-9.12；95%CI：-16.90 至-1.34）。两组患者住院期间（RR=1.50；95%CI：0.73 至 3.09）或更长时间（≥6 个月）全因死亡率（RR=1.10；95%CI：0.86 至 1.42）均无统计学差异。
女性患者 CTO PCI 是可行且安全的，其结局与男性患者相当。
