Impact of Sex on Clinical Outcomes in Patients undergoing Complex Percutaneous Coronary Angioplasty (from the e-ULTIMASTER Study)

Gemina Doolub; Pim A.L. Tonino; Sasko Kedev; Jacques Monségu; Valeria Paradies; David Austin; Fabrizio Spanó; Marco Roffi; Ole Fröbert; Clemens von Birgelen; Louise Buchanan; Mamas A. Mamas; e-ULTIMASTER investigators

doi:10.1016/j.amjcard.2022.10.023

Impact of Sex on Clinical Outcomes in Patients undergoing Complex Percutaneous Coronary Angioplasty (from the e-ULTIMASTER Study)

Gemina Doolub^*, Pim A.L. Tonino, Sasko Kedev, Jacques Monségu, Valeria Paradies, David Austin, Fabrizio Spanó, Marco Roffi, Ole Fröbert, Clemens von Birgelen, Louise Buchanan, Mamas A. Mamas, e-ULTIMASTER investigators

^*Corresponding author for this work

Research output: Contribution to journal/Conference contribution in journal/Contribution to newspaper › Journal article › Research › peer-review

1 Citation (Scopus)

Abstract

Female gender has been shown to be associated with worse clinical outcomes after percutaneous coronary intervention (PCI). However, the impact of gender on the clinical outcomes of complex PCI is still poorly understood. This study examined the differences in patient and coronary lesion characteristics and longer-term clinical outcomes in male and female patients who underwent complex PCI. This was a sub-analysis of the e-ULTIMASTER study, which was a large, multicontinental, prospective, observational study enrolling 37,198 patients who underwent PCI with the Ultimaster stent. Patients who underwent complex PCI were stratified by gender. The primary outcome was target lesion failure at 12 months, defined as the composite of cardiac death, target vessel-related myocardial infarction, and clinically driven target lesion revascularization at 12 months. A total of 13,623 patients underwent complex procedures, of which 35.7% were women. Women were twice as likely as men to be aged ≥80 years (17.6% vs 9%, p <0.0001) and had a higher prevalence of cardiovascular risk factors. Women had fewer lesions treated than men (1.5 ± 0.8 vs 1.6 ± 0.8, p <0.0001) and fewer stents implanted (2.0 ± 1.1 vs 2.1 ± 1.1, p <0.0001). There was no statistically significant difference in clinical outcomes at 12 months between women and men. Event rates were comparable in women and men for target lesion failure (4.7% vs 4.3%, p = 0.30), target vessel failure (5.1% vs 4.9%, p = 0.73), and cardiac death (1.8% vs 1.7%, p = 0.80).In conclusion, our findings suggest no significant differences in clinical outcomes between women and men who underwent complex PCI.

Original language	English
Journal	American Journal of Cardiology
Volume	186
Pages (from-to)	71-79
Number of pages	9
ISSN	0002-9149
DOIs	https://doi.org/10.1016/j.amjcard.2022.10.023
Publication status	Published - Jan 2023
Externally published	Yes

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10.1016/j.amjcard.2022.10.023

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Doolub, G., Tonino, P. A. L., Kedev, S., Monségu, J., Paradies, V., Austin, D., Spanó, F., Roffi, M., Fröbert, O., von Birgelen, C., Buchanan, L., Mamas, M. A., & e-ULTIMASTER investigators (2023). Impact of Sex on Clinical Outcomes in Patients undergoing Complex Percutaneous Coronary Angioplasty (from the e-ULTIMASTER Study). American Journal of Cardiology, 186, 71-79. https://doi.org/10.1016/j.amjcard.2022.10.023

@article{e46979fc11e84f7a97b4d754f8832af4,

title = "Impact of Sex on Clinical Outcomes in Patients undergoing Complex Percutaneous Coronary Angioplasty (from the e-ULTIMASTER Study)",

abstract = "Female gender has been shown to be associated with worse clinical outcomes after percutaneous coronary intervention (PCI). However, the impact of gender on the clinical outcomes of complex PCI is still poorly understood. This study examined the differences in patient and coronary lesion characteristics and longer-term clinical outcomes in male and female patients who underwent complex PCI. This was a sub-analysis of the e-ULTIMASTER study, which was a large, multicontinental, prospective, observational study enrolling 37,198 patients who underwent PCI with the Ultimaster stent. Patients who underwent complex PCI were stratified by gender. The primary outcome was target lesion failure at 12 months, defined as the composite of cardiac death, target vessel-related myocardial infarction, and clinically driven target lesion revascularization at 12 months. A total of 13,623 patients underwent complex procedures, of which 35.7% were women. Women were twice as likely as men to be aged ≥80 years (17.6% vs 9%, p <0.0001) and had a higher prevalence of cardiovascular risk factors. Women had fewer lesions treated than men (1.5 ± 0.8 vs 1.6 ± 0.8, p <0.0001) and fewer stents implanted (2.0 ± 1.1 vs 2.1 ± 1.1, p <0.0001). There was no statistically significant difference in clinical outcomes at 12 months between women and men. Event rates were comparable in women and men for target lesion failure (4.7% vs 4.3%, p = 0.30), target vessel failure (5.1% vs 4.9%, p = 0.73), and cardiac death (1.8% vs 1.7%, p = 0.80).In conclusion, our findings suggest no significant differences in clinical outcomes between women and men who underwent complex PCI.",

author = "Gemina Doolub and Tonino, {Pim A.L.} and Sasko Kedev and Jacques Mons{\'e}gu and Valeria Paradies and David Austin and Fabrizio Span{\'o} and Marco Roffi and Ole Fr{\"o}bert and {von Birgelen}, Clemens and Louise Buchanan and Mamas, {Mamas A.} and {e-ULTIMASTER investigators}",

note = "Publisher Copyright: {\textcopyright} 2022 Elsevier Inc.",

year = "2023",

month = jan,

doi = "10.1016/j.amjcard.2022.10.023",

language = "English",

volume = "186",

pages = "71--79",

journal = "American Journal of Cardiology",

issn = "0002-9149",

publisher = "Elsevier Inc.",

}

Doolub, G, Tonino, PAL, Kedev, S, Monségu, J, Paradies, V, Austin, D, Spanó, F, Roffi, M, Fröbert, O, von Birgelen, C, Buchanan, L, Mamas, MA & e-ULTIMASTER investigators 2023, 'Impact of Sex on Clinical Outcomes in Patients undergoing Complex Percutaneous Coronary Angioplasty (from the e-ULTIMASTER Study)', American Journal of Cardiology, vol. 186, pp. 71-79. https://doi.org/10.1016/j.amjcard.2022.10.023

Impact of Sex on Clinical Outcomes in Patients undergoing Complex Percutaneous Coronary Angioplasty (from the e-ULTIMASTER Study). / Doolub, Gemina; Tonino, Pim A.L.; Kedev, Sasko et al.
In: American Journal of Cardiology, Vol. 186, 01.2023, p. 71-79.

Research output: Contribution to journal/Conference contribution in journal/Contribution to newspaper › Journal article › Research › peer-review

TY - JOUR

T1 - Impact of Sex on Clinical Outcomes in Patients undergoing Complex Percutaneous Coronary Angioplasty (from the e-ULTIMASTER Study)

AU - Doolub, Gemina

AU - Tonino, Pim A.L.

AU - Kedev, Sasko

AU - Monségu, Jacques

AU - Paradies, Valeria

AU - Austin, David

AU - Spanó, Fabrizio

AU - Roffi, Marco

AU - Fröbert, Ole

AU - von Birgelen, Clemens

AU - Buchanan, Louise

AU - Mamas, Mamas A.

AU - e-ULTIMASTER investigators

PY - 2023/1

Y1 - 2023/1

N2 - Female gender has been shown to be associated with worse clinical outcomes after percutaneous coronary intervention (PCI). However, the impact of gender on the clinical outcomes of complex PCI is still poorly understood. This study examined the differences in patient and coronary lesion characteristics and longer-term clinical outcomes in male and female patients who underwent complex PCI. This was a sub-analysis of the e-ULTIMASTER study, which was a large, multicontinental, prospective, observational study enrolling 37,198 patients who underwent PCI with the Ultimaster stent. Patients who underwent complex PCI were stratified by gender. The primary outcome was target lesion failure at 12 months, defined as the composite of cardiac death, target vessel-related myocardial infarction, and clinically driven target lesion revascularization at 12 months. A total of 13,623 patients underwent complex procedures, of which 35.7% were women. Women were twice as likely as men to be aged ≥80 years (17.6% vs 9%, p <0.0001) and had a higher prevalence of cardiovascular risk factors. Women had fewer lesions treated than men (1.5 ± 0.8 vs 1.6 ± 0.8, p <0.0001) and fewer stents implanted (2.0 ± 1.1 vs 2.1 ± 1.1, p <0.0001). There was no statistically significant difference in clinical outcomes at 12 months between women and men. Event rates were comparable in women and men for target lesion failure (4.7% vs 4.3%, p = 0.30), target vessel failure (5.1% vs 4.9%, p = 0.73), and cardiac death (1.8% vs 1.7%, p = 0.80).In conclusion, our findings suggest no significant differences in clinical outcomes between women and men who underwent complex PCI.

AB - Female gender has been shown to be associated with worse clinical outcomes after percutaneous coronary intervention (PCI). However, the impact of gender on the clinical outcomes of complex PCI is still poorly understood. This study examined the differences in patient and coronary lesion characteristics and longer-term clinical outcomes in male and female patients who underwent complex PCI. This was a sub-analysis of the e-ULTIMASTER study, which was a large, multicontinental, prospective, observational study enrolling 37,198 patients who underwent PCI with the Ultimaster stent. Patients who underwent complex PCI were stratified by gender. The primary outcome was target lesion failure at 12 months, defined as the composite of cardiac death, target vessel-related myocardial infarction, and clinically driven target lesion revascularization at 12 months. A total of 13,623 patients underwent complex procedures, of which 35.7% were women. Women were twice as likely as men to be aged ≥80 years (17.6% vs 9%, p <0.0001) and had a higher prevalence of cardiovascular risk factors. Women had fewer lesions treated than men (1.5 ± 0.8 vs 1.6 ± 0.8, p <0.0001) and fewer stents implanted (2.0 ± 1.1 vs 2.1 ± 1.1, p <0.0001). There was no statistically significant difference in clinical outcomes at 12 months between women and men. Event rates were comparable in women and men for target lesion failure (4.7% vs 4.3%, p = 0.30), target vessel failure (5.1% vs 4.9%, p = 0.73), and cardiac death (1.8% vs 1.7%, p = 0.80).In conclusion, our findings suggest no significant differences in clinical outcomes between women and men who underwent complex PCI.

UR - http://www.scopus.com/inward/record.url?scp=85141452547&partnerID=8YFLogxK

U2 - 10.1016/j.amjcard.2022.10.023

DO - 10.1016/j.amjcard.2022.10.023

M3 - Journal article

C2 - 36368145

AN - SCOPUS:85141452547

SN - 0002-9149

VL - 186

SP - 71

EP - 79

JO - American Journal of Cardiology

JF - American Journal of Cardiology

ER -

Impact of Sex on Clinical Outcomes in Patients undergoing Complex Percutaneous Coronary Angioplasty (from the e-ULTIMASTER Study)

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