Gender-Related Outcomes in Saphenous Vein Graft Interventions.

BACKGROUND

Saphenous vein graft percutaneous coronary intervention (SVG-PCI) is a relatively common procedure in patients after coronary artery bypass grafting (CABG). Although internal mammary artery is considered optimal, SVG is still used in the majority of patients.

AIMS

Investigating the potential role of gender differences in the incidence and outcomes of SVG-PCI.

METHODS

The study was based on a prospectively collected registry of 1199 consecutive patients (169 female) who underwent SVG-PCI in a tertiary medical center between 2004 and 2023. Primary outcomes included MACE (death, myocardial infarction [MI], target vessel revascularization [TVR], stroke) and mortality, at 1 and 3 years.

RESULTS

Female patients were older (73.6 ± 9.1 years vs. 70.6 ± 9.7 years, p < 0.001), suffered from higher rates of diabetes mellitus, peripheral vascular disease, and congestive heart failure (78.1% vs. 61.3% p < 0.001, 13.6% vs. 7% p < 0.003, 66.3% vs. 51.8% p < 0.001 respectively). Additionally, female patients had lower trans-radial access use (11.9% vs. 19.3%, p < 0.025), and underwent SVG-PCI earlier following their CABG procedure (11.3 ± 6.2 years vs 12.9 ± 6.1 years, p < 0.003), as compared to male patients. There were no differences in MACE rates between the groups. Mortality was higher in the female group at 1 year (13.6% vs. 6.9%, p = 0.003), but no significant differences were observed at 3 years (24.3% vs. 20.9%, p = 0.320). Cox regression analysis identified age, renal function, ejection fraction, MI and trans-femoral as independent risk factors for mortality.

CONCLUSION

Gender-specific monitoring and early intervention, especially for women, are required for better management of graft patency, potentially improving long-term outcomes.