Key result
Female gender was associated with a lower prevalence of chronic total occlusions (19% vs. 30%, P<0.001) and lower rates of CABG treatment for CTOs compared to men (19% vs. 27%, P=0.003).
Why the study?
Are there gender differences in the prevalence, comorbidities, and revascularization treatment of coronary chronic total occlusions?
Observational (n=9,372)
Yes
Are there gender differences in the prevalence, comorbidities, and revascularization treatment of coronary chronic total occlusions?
Absolute Event Rate: 19% vs 27%
p-value: p=0.003
Female gender is an independent predictor for not receiving CABG treatment for CTO, and women have a lower prevalence of CTOs at angiography.
Women with CTOs may face differential CABG referral; leaves open whether differences reflect biology, selection, or access barriers.
BACKGROUND: Gender differences exist in the presentation and outcomes of patients with coronary artery disease (CAD). Our study objective was to compare gender differences in prevalence, co-morbidities, and revascularization treatment in CAD patients with chronic total occlusions (CTOs). METHODS: A retrospective analysis using the Canadian Multicenter CTO Registry, which included 1,690 consecutive CTO patients identified at coronary angiography and a control group of 7,682 non-CTO patients. RESULTS: The prevalence of women in the CTO group was significantly lower compared to the control group (19% vs. 30%, P < 0.001). Within the overall CTO group, women were significantly older than men (70 ± 12 vs. 66 ± 11 years, P < 0.001) with more comorbidities, including hypertension and heart failure. Rates of PCI in the CTO group were similar between gender (10%), however, women with CTO were treated significantly less by CABG compared to men (19% vs. 27%, P = 0.003). Moreover, compared to male patients, significantly fewer women undergoing CABG had revascularization of the CTO artery (84% vs. 93%, P = 0.03). Multivariable analysis indicated that female gender (along with age, chronic renal failure, prior MI and cerebro-vascular disease) were independent predictors for not receiving CABG treatment for CTO. CONCLUSIONS: Female gender differences exist in CTO patients with both lower prevalence of CTOs at angiography and lower revascularization rates of CTOs by CABG.
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Wolff et al. (2015) conducted an observational in Coronary artery disease with chronic total occlusions (n=9,372). Female gender vs. Male gender was evaluated on CABG treatment for CTO (p=0.003). Female gender was associated with a lower prevalence of chronic total occlusions (19% vs. 30%, P<0.001) and lower rates of CABG treatment for CTOs compared to men (19% vs. 27%, P=0.003).
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