Comparação do perfil epidemiológico, clínico e dos resultados das intervenções coronárias percutâneas entre os gêneros masculino e feminino, na população brasileira: Dados do registro CENIC

Translated title of the contribution: Comparison of the epidemiologic and clinical profiles and results of percutaneous coronary interventions in men and women in Brazil: The CENIC registry data

Marcelo Antônio Cartaxo Queiroga Lopes, Marco Antonio De Vivo Barros, Itamar Ribeiro De Oliveira, Helman Campos Martins, Maria Sanali Paiva, João Alfredo Cunha Lima, Gustavo Souto Maior, Hugo Diógenes De Oliveira Paiva, Luiz Alberto Mattos, José Antonio Marin-Neto

Research output: Contribution to journalArticle

Abstract

Background: There are major challenges in diagnosing and treating women with coronary artery disease (CAD), particularly in randomized and controlled studies. These notions are more controversial in the real world, especially with respect to percutaneous coronary intervention (PCI). Objective: To compare results from in-hospital PCI procedures in male and female Brazilian patients. Method: A retrospective analysis was done, based on data electronically uploaded into the CENIC (Central Nacional de Intervenções Cardiovasculares) Registry. A standardized form to gather data from patients treated between the beginning of 1999 to the end of 2007 was used and included clinical, angiographic and procedural results, including clinical success and complications. Results: In this period, 197,139 coronary interventions were reported; 131,797 (66.85%) in men and 65,342 (33.15%) in women. Women were older (64.0 ± 11.6 yrs vs. 60.4 ± 11.7 yrs; p < 0.0001), and had a higher prevalence of diabetes mellitus (39.4% vs. 28.5%; p < 0.0001). In contrast, men showed a higher prevalence of hypertension (25.6% vs. 28.9%; p < 0.0001), smoking (19.1% vs. 34.0%; p < 0.0001), previous myocardial infarction (21.1% vs. 26.8%; p < 0.0001), previous PCI (17.5% vs. 19.3%; p < 0,0001) and previous coronary artery bypass surgery (8.3% vs. 11.0%; p < 0.0001). In male patients with previous PCI, new interventions were done more frequently due to disease progression (56.6% vs. 59.5%; p < 0.006) whereas in women they were done predominantly due to restenosis (39.2% vs. 36.4%; p < 0.0001). PCI was performed in women more often than in men due to unstable clinical conditions (56.5% vs. 55.8%; p = 0.003). Angiographically, a higher number of single vessel lesions was noted among women (53.2% vs. 49.3%; p < 0.0001) as well as a lesser prevalence of severe left ventricle dysfunction (4.1% vs. 4.6%; p < 0.0001), complex lesions (B2 and C) (64.3% vs. 66.0%; p < 0.0001), visible thrombus (14.6% vs. 17.6%; p < 0.0001), lesions > 20 mm (26.6% vs. 28.1%; p < 0.0001) and involvement of secondary branches (26.6% vs. 27.6%; p < 0.0001). In contrast, in women there was higher rate of calcified lesions (23.4% vs. 22.8%; p < 0.0001) and a smaller vessel diameter (2.95 mm ± 0.66 mm vs. 3.04 mm ± 0.75 mm; p = 0,001) and stent length (17.2 mm ± 7.1 mm vs. 17.7 mm ± 7.3 mm; p = 0.04) was observed. Women tend to have a higher rate of unsuccessful procedures (0.75% vs. 0.68%; p = 0,077), and presented higher rates of death (1.20% vs. 0.79%; p < 0.0001) and non-fatal myocardial infarction (0.54% vs. 0.41%; p < 0.0001). Conclusion: PCI performed in female Brazilian patients showed a slightly less favorable in-hospital results compared to male patients and was associated, among other factors, to a triad of more advanced age, higher prevalence of diabetes mellitus and, probably, a smaller vessel diameter.

Translated title of the contributionComparison of the epidemiologic and clinical profiles and results of percutaneous coronary interventions in men and women in Brazil: The CENIC registry data
Original languagePortuguese
Pages (from-to)463-473
Number of pages11
JournalRevista Brasileira de Cardiologia Invasiva
Volume16
Issue number4
StatePublished - Jan 1 2008
Externally publishedYes

Keywords

  • Angioplasty
  • Angioplasty, transluminal, percutaneous coronary
  • Gender and health
  • Risk factors
  • Sex factors
  • Treatment outcome

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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    Lopes, M. A. C. Q., Barros, M. A. D. V., De Oliveira, I. R., Martins, H. C., Paiva, M. S., Lima, J. A. C., Maior, G. S., Paiva, H. D. D. O., Mattos, L. A., & Marin-Neto, J. A. (2008). Comparação do perfil epidemiológico, clínico e dos resultados das intervenções coronárias percutâneas entre os gêneros masculino e feminino, na população brasileira: Dados do registro CENIC. Revista Brasileira de Cardiologia Invasiva, 16(4), 463-473.