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采用双吻裤裙式和裤裙式技术行分叉支架置入术治疗的急性冠状动脉综合征患者临床特征及预后的性别差异——1年随访

Sex Differences in Clinical Features and Outcomes in Patients with Acute Coronary Syndrome Treated with Bifurcation Stenting Using the Double-Kissing Culotte and Culotte Technique - 1-year Follow-up.

作者信息

Włodarczak Piotr, Barycki Mateusz, Włodarczak Szymon, Furtan Łukasz, Giniewicz Andrzej, Chudaś Anita, Banasiak Waldemar, Doroszko Adrian, Lesiak Maciej, Włodarczak Adrian, Rola Piotr

机构信息

Department of Cardiology, The Copper Health Centre (MCZ), Lubin, 59-301, Poland.

Department of Cardiology, Provincial Specialized Hospital, Legnica, 59-220, Poland.

出版信息

Vasc Health Risk Manag. 2025 May 7;21:361-370. doi: 10.2147/VHRM.S513926. eCollection 2025.

Abstract

PURPOSE

Sex differences in the clinical course of coronary artery disease (CAD) particularly in Acute Coronary Syndrome (ACS), have been extensively hypothesized. Although coronary bifurcations account for approximately 20% of ACS cases, data concerning potential sex disparities in the outcomes of percutaneous interventions (PCI) remain scarce. Several data suggest the double kiss (DK) Culotte may provide advantages in bifurcation PCI. Therefore, we evaluate potential sex differences in relation to the Culotte technique.

PATIENTS AND METHODS

This study retrospectively analyzes sex disparities following PCI interventions in ACS patients using the DK-Culotte or Culotte technique for bifurcation lesions. The primary endpoint was Target Lesion Failure (TLF), a composite of cardiovascular death, target vessel myocardial infarction, or clinically driven target lesion revascularization (TLR). The secondary endpoint included major adverse cardiac events MACE (myocardial infarction, cardiac death, and target lesion revascularization).

RESULTS

There were no significant differences between sexes regarding TLF (DK-Culotte: Females 10.3% vs Males 5.7%; p=0.401; Culotte: Females 16.2% vs Males 11.8%; p=0.481) or MACE (DK-Culotte: Females 13.8% vs Males 12.5%; p=0.771; Culotte: Females 24.3% vs Males 17.6%; p=0.370) after a 1-year follow-up for both bifurcation techniques.

CONCLUSION

The study found no significant differences in clinical outcomes between sexes following PCI for bifurcation lesions in the ACS cohort, regardless of whether the two-stent techniques (DK- Culotte or Culotte) were used.

摘要

目的

冠状动脉疾病(CAD)临床病程中的性别差异,尤其是急性冠状动脉综合征(ACS)中的性别差异,已被广泛提出假设。尽管冠状动脉分叉病变约占ACS病例的20%,但关于经皮介入治疗(PCI)结果中潜在性别差异的数据仍然很少。一些数据表明双吻(DK)裤裙式技术可能在分叉病变PCI中具有优势。因此,我们评估了与裤裙式技术相关的潜在性别差异。

患者和方法

本研究回顾性分析了使用DK-裤裙式或裤裙式技术治疗分叉病变的ACS患者PCI术后的性别差异。主要终点是靶病变失败(TLF),即心血管死亡、靶血管心肌梗死或临床驱动的靶病变血运重建(TLR)的复合终点。次要终点包括主要不良心脏事件MACE(心肌梗死、心脏死亡和靶病变血运重建)。

结果

在对两种分叉技术进行1年随访后,男女在TLF(DK-裤裙式:女性10.3% vs男性5.7%;p = 0.401;裤裙式:女性16.2% vs男性11.8%;p = 0.481)或MACE(DK-裤裙式:女性13.8% vs男性12.5%;p = 0.771;裤裙式:女性24.3% vs男性17.6%;p = 0.370)方面均无显著差异。

结论

该研究发现,在ACS队列中,无论是否使用双支架技术(DK-裤裙式或裤裙式),分叉病变PCI术后男女临床结局均无显著差异。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4488/12067469/343d06eff936/VHRM-21-361-g0001.jpg

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