The Effect of Sex and Anthropometry on Clinical Outcomes in Patients Undergoing Percutaneous Coronary Intervention for Complex Coronary Lesions

• Published in: Yonsei medical journal Vol. 58; no. 2; pp. 296 - 304
• Main Authors: Lee, Seung-Yul, Shin, Dong-Ho, Kim, Jung-Sun, Kim, Byeong-Keuk, Ko, Young-Guk, Choi, Donghoon, Jang, Yangsoo, Hong, Myeong-Ki
• Format: Journal Article
• Language: English
• Published: Korea (South) Yonsei University College of Medicine 01.03.2017; 연세대학교의과대학
• Subjects: Aged; Anthropometry; Coronary Angiography - adverse effects; Coronary Artery Disease - diagnosis; Coronary Artery Disease - therapy; Coronary Vessels - diagnostic imaging; Drug-Eluting Stents - adverse effects; Female; Humans; Incidence; Male; Middle Aged; Myocardial Infarction - epidemiology; Myocardial Infarction - etiology; Original; Percutaneous Coronary Intervention - adverse effects; Propensity Score; Proportional Hazards Models; Sirolimus - administration & dosage; Sirolimus - adverse effects; Sirolimus - analogs & derivatives; Time Factors; Treatment Outcome; Ultrasonography, Interventional; 의학일반; Coronary artery disease; intravascular ultrasound; sex
• ISSN: 0513-5796; 1976-2437; 1976-2437
• DOI: 10.3349/ymj.2017.58.2.296

To evaluate the effects of sex and anthropometry on clinical outcomes in patients who underwent percutaneous coronary intervention (PCI). From three randomized trials (REal Safety and Efficacy of 3-month dual antiplatelet Therapy following Endeavor zotarolimus-eluting stent implantation, Impact of intraVascular UltraSound guidance on outcomes of Xience Prime stents in Long lesions, Chronic Total Occlusion InterVention with drUg-eluting Stents), we compared 333 pairs of men and women matched by propensity scores, all of whom underwent intravascular ultrasound (IVUS)-guided PCI for complex lesions. For 12 months, the incidence of adverse cardiac events, defined as the composite of cardiac death, target lesion-related myocardial infarction, and target lesion revascularization, was not different between women and men (2.4% vs. 2.4%, p=0.939). Using multivariable Cox's regression analysis, post-intervention minimum lumen area [MLA; hazard ratio (HR)=0.620, 95% confidence interval (CI)=0.423-0.909, p=0.014] by IVUS was a predictor of adverse cardiac events. Height on anthropometry and lesions with chronic total occlusion were significantly related to post-intervention MLA. However, female sex was not independently associated with post-intervention MLA. In an age and sex-adjusted model, patients in the low tertile of height exhibited a greater risk for adverse cardiac events than those in the high tertile of height (HR=6.391, 95% CI=1.160-35.206, p=0.033). Sex does not affect clinical outcomes after PCI for complex lesions. PCI outcomes, however, may be adversely affected by height.