Is female gender associated with worse outcomes after percutaneous coronary intervention of left main coronary artery?

Introduction Left main coronary artery (LM) disease is a life-threatening condition, so the invasive treatment is crucial for the survival of the patients. There is still controversy regarding whether female sex is associated with worse outcomes after percutaneous coronary intervention (PCI) of LM. Purpose Our aim was to examine gender-based differences in patients after LM PCI. Methods Consecutive 459 patients (mean age: 68.4±9.4 years) in whom PCI of LM was performed (between January 2015 and June 2018) were included in the study. The clinical and angiographic data of these patients including short and long-term outcomes has been analyzed. Results The whole group consisted of 112 (24.4%) women and 347 (75.6%) men. Compared with men, women were older (69.9±8.9 vs 67.9±9.5; p=0.04), had higher prevalence rates of diabetes (43.8% vs 33.4%; p=0.048) and hypertension (92% vs 79.1%; p<0.01). Renal failure (42% vs 32.3%; p=0.061) was found insignificantly more often in women, frequency of other comorbidities did not differ statistically. Women were more often disqualified from bypass surgery (19.6% vs 11.8%; p=0.036) and more often required complex stenting techniques (29.2% vs 18.7%; p=0.028). SYNTAX Score and Euroscore II did not differ statistically between the genders. All periprocedural complications (8.9% vs 8.4%; p=0.85) and the frequency of periprocedural myocardial infarction (6.3% vs 4%; p=0.330) did not differ among the groups. We observed higher all-cause mortality in men group (19.1% vs 24.3%; p=0.041) at a median follow-up of 808 days (range 367 to 1616 days). Conclusion In our real-life cohort of patients, complex LM procedures and comorbidities were more frequent in women. There was no significant difference in short-term results between two genders, although in our real-life study we observed higher long-term all-cause mortality in men. Our results suggest that female gender in LM PCI is not a predictor of adverse outcomes. Further studies are required to determine the optimal revascularization modality in women. Long-term follow-up Funding Acknowledgement Type of funding source: None