Impact of Sex on Outcomes Among Patients With Cardiac Allograft Vasculopathy Who Undergo Percutaneous Coronary Intervention

• Published in: The Journal of invasive cardiology Vol. 32; no. 12; pp. 453 - 458
• Main Authors: Lee, Michael S, Wadia, Subeer K, Shlofmitz, Richard
• Format: Journal Article
• Language: English
• Published: United States 01.12.2020
• Subjects: cardiac allograft vasculopathy; percutaneous coronary intervention; orthotopic heart transplant
• ISSN: 1557-2501

Orthotopic heart transplantation (OHT) is a reasonable treatment strategy for patients with endstage heart failure. Percutaneous coronary intervention (PCI) can be performed to treat cardiac allograft vasculopathy (CAV). We sought to examine sex-based differences and outcomes in patients undergoing PCI for CAV. This was a single- center, retrospective study of consecutive patients undergoing PCI for CAV from July 1993 to July 2017. The primary outcome was a composite of death, myocardial infarction (MI), target-vessel revascularization (TVR), or repeat OHT. A total of 140 patients (39% women) who underwent PCI for CAV were studied over a median follow-up of 3.9 years. Women were more likely to be younger and had less hypertension, with a trend toward less diabetes and higher ejection fractions. No significant differences in the primary composite outcome were noted between women and men (hazard ratio, 1.16; 95% confidence interval, 0.76-1.76; P=.49), as well as the individual outcomes of death, MI, or TVR (P>.05 for all). Women were more likely to undergo repeat OHT than men (hazard ratio, 2.93; 95% confidence interval, 1.48-5.81; P<.01). After covariate adjustment, female sex and younger age were independently associated with repeat OHT for CAV (P<.05). No differences in the primary outcome as well as the individual outcomes of death, MI, or TVR were noted between sex groups in patients who underwent PCI for CAV. Female patients were more likely to undergo redo OHT for CAV. Younger age at time of initial OHT was associated with a need for repeat OHT.