Siudak Zbigniew, Bryniarski Leszek, Malinowski Krzysztof Piotr, Wańha Wojciech, Wojakowski Wojciech, Surowiec Sławomir, Balan Robert, Januszek Sławomir, Pawlik Artur, Siwiec Natalia, Bryniarski Krzysztof, Surdacki Andrzej, Legutko Jacek, Bartuś Krzysztof, Bartuś Stanisław, Januszek Rafał
Faculty of Medicine and Health Sciences, Jan Kochanowski University, 25-317 Kielce, Poland.
2nd Department of Cardiology and Cardiovascular Interventions, Institute of Cardiology, Jagiellonian University Medical College, 31-202 Krakow, Poland.
J Clin Med. 2022 Mar 4;11(5):1419. doi: 10.3390/jcm11051419.
It has been demonstrated that gender differences are related to different procedural and long-term clinical outcomes among a general patient population treated using percutaneous coronary interventions (PCI). The objective of our analysis was to conduct assessment regarding the relationship between gender and procedural outcomes in patients treated for PCI regarding chronic total occlusions (CTO), based on a large, real-life registry. Data used to conduct the following analysis was derived from the national registry of percutaneous coronary interventions (ORPKI), upheld in co-operation with the Association of Cardiovascular Interventions (AISN) of the Polish Cardiac Society. The study involved data procured from the registry within the period from January 2014 to December 2020. All subsequent CTO procedures recorded in the registry during that period were included in the analysis. We assessed the correlation between gender and the overall rate of periprocedural complications, procedure-related mortality, and success evaluated as TIMI flow grade 3 after the procedure by univariate and multivariable modeling. At the time of conducting our investigation, there were 162 existing and active CathLabs, at which 747,033 PCI procedures were carried out during the observational period. Of those, 14,903 (1.99%) were CTO-PCI procedures, and 3726 were women (25%). The percentage share between genders did not experience any significant changes during the consecutive years observed in the current analysis. Overall periprocedural complication rate was greater among women than men (3.45% vs. 2.31%, p = 0.02). A comparable relationship was noted for procedural mortality (0.7% vs. 0.2%, p = 0.006), while procedural success occurred more often in the case of women (69.3% vs. 65.2%, p < 0.001). Women were found to be more frequently affected by periprocedural complications (OR = 1.553; 95%CI: 1.212−1.99, p < 0.001) as well as procedural success (OR = 1.294; 95%CI: 1.151−1.454, p < 0.001), evaluated using multivariable models. Based on the current analysis performed on all-comer patients treated using PCI in CTO, women are affected by more frequent procedural complication occurrence as well as greater procedural success compared to men.
已经证明，在接受经皮冠状动脉介入治疗（PCI）的普通患者群体中，性别差异与不同的手术过程和长期临床结果相关。我们分析的目的是基于一个大型的真实世界注册研究，评估在接受慢性完全闭塞（CTO）的PCI治疗的患者中，性别与手术结果之间的关系。用于进行以下分析的数据来自与波兰心脏病学会心血管介入协会（AISN）合作维护的国家经皮冠状动脉介入注册研究（ORPKI）。该研究涉及2014年1月至2020年12月期间从注册研究中获取的数据。该期间注册研究中记录的所有后续CTO手术均纳入分析。我们通过单变量和多变量建模评估了性别与围手术期并发症总发生率、手术相关死亡率以及术后TIMI血流3级评估的成功率之间的相关性。在我们进行调查时，有162个现有的活跃心导管室，在观察期内共进行了747,033例PCI手术。其中，14,903例（1.99%）为CTO-PCI手术，女性为3726例（25%）。在当前分析观察的连续几年中，性别之间的百分比份额没有发生任何显著变化。女性的总体围手术期并发症发生率高于男性（3.45%对2.31%，p = 0.02）。手术死亡率也呈现类似关系（0.7%对0.2%，p = 0.006），而女性手术成功率更高（69.3%对65.2%，p < 0.001）。使用多变量模型评估发现，女性更频繁地受到围手术期并发症影响（OR = 1.553；95%CI：1.212 - 1.99，p < 0.001）以及手术成功（OR = 1.294；95%CI：1.151 - 1.454，p < 0.001）。基于目前对所有接受CTO的PCI治疗患者的分析，与男性相比，女性更容易出现手术并发症，同时手术成功率更高。
