Khanal Resha, Hamza Mohammad, Najam Maria, Basit Salman Abdul, Wajid Zarghoona, Rashdi Amna, Patel Neel, Razzaq Saman, Shah Rajendra, Harmouch Khaled M, Alyami Bandar, Bahar Yasemin, Aamir Muhammad, Abu-Mahfouz Mohammed, Sattar Yasar, Alraies M Chadi
Department of Internal Medicine, Wayne Health University/Detroit Medical Center Detroit, MI, USA.
Guthrie Medical Group Cortland, NY, USA.
Am J Cardiovasc Dis. 2024 Jun 15;14(3):136-143. doi: 10.62347/YBJN2231. eCollection 2024.
Around 15-20% of lesions necessitating percutaneous coronary interventions (PCI) are attributed to coronary bifurcation lesions. We aim to study gender-based differences in PCI outcomes among bifurcation stents.
3 studies were included after thorough systematic search using MEDLINE (EMBASE and PubMed). CRAN-R software using the Metabin module was used for statistical analysis. Pooled odds ratios (OR) were calculated using the random effect model and the Mantel-Haenszel method, with a 95% confidence interval (CI) used to determine statistical significance. Heterogeneity was assessed using Higgins I.
Women exhibited a higher risk of in-hospital mortality (OR 0.67, 95% CI 0.58-0.76, I = 0%, P < 0.0001), post-procedural bleeding (OR 0.53, 95% CI 0.47-0.6, I = 0%, P < 0.0001) and post-procedure stroke (OR 0.72, 95% CI 0.52-1.0, I = 0%, P < 0.06) as compared to men. However, there were no significant differences in terms of myocardial infarction (OR 0.84, 95% CI 0.22-3.27, I = 49.4%, P < 0.80) and cardiac tamponade (OR 0.63, 95% CI 0.06; 5.72, I = 0%, P < 0.6821) in both groups.
Our study reveals a noteworthy increase in in-hospital mortality in women, which could be attributed to a higher rate of major bleeding, advanced age, increased co-morbidities, and complex pathophysiology of the lesion in comparison to men. Further studies are required to gain a better understanding of the precise mechanisms thus enhancing procedural outcomes.
约15%-20%需要进行经皮冠状动脉介入治疗（PCI）的病变归因于冠状动脉分叉病变。我们旨在研究分叉支架PCI结果中的性别差异。
通过使用MEDLINE（EMBASE和PubMed）进行全面系统检索后纳入3项研究。使用CRAN-R软件的Metabin模块进行统计分析。采用随机效应模型和Mantel-Haenszel方法计算合并比值比（OR），并使用95%置信区间（CI）确定统计学显著性。使用Higgins I评估异质性。
与男性相比，女性住院死亡率（OR 0.67，95% CI 0.58-0.76，I = 0%，P < 0.0001）、术后出血（OR 0.53，95% CI 0.47-0.6，I = 0%，P < 0.0001）和术后中风（OR 0.72，95% CI 0.52-1.0，I = 0%，P < 0.06）的风险更高。然而，两组在心肌梗死（OR 0.84，95% CI 0.22-3.27，I = 49.4%，P < 0.80）和心脏压塞（OR 0.63，95% CI 0.06；5.72，I = 0%，P < 0.6821）方面无显著差异。
我们的研究显示女性住院死亡率显著增加，这可能归因于与男性相比更高的大出血发生率、高龄、合并症增加以及病变复杂的病理生理学。需要进一步研究以更好地理解确切机制，从而改善手术结果。
