Abstract：
Gender-specific data addressing percutaneous coronary intervention (PCI) of chronic total occlusion (CTO) in female patients are scarce and based on small sample size studies.
We aimed to analyze gender-differences regarding in-hospital clinical outcomes after CTO-PCI.
Data from 35,449 patients enrolled in the prospective European Registry of CTOs were analyzed. The primary outcome was the comparison of procedural success rate in the two cohorts (women vs. men), defined as a final residual stenosis less than 20%, with Thrombolysis In Myocardial Infarction grade flow = 3. In-hospital major adverse cardiac and cerebrovascular events (MACCEs) and procedural complications were deemed secondary outcomes.
Women represented 15.2% of the entire study population. They were older and more likely to have hypertension, diabetes, and renal failure, with an overall lower J-CTO score. Women showed a higher procedural success rate (adjusted OR [aOR] = 1.115, confidence interval [CI]: 1.011-1.230, p = 0.030). Apart from previous myocardial infarction and surgical revascularization, no other significant gender differences were found among predictors of procedural success. Antegrade approach with true-to-true lumen techniques was more commonly used than retrograde approach in females. No gender differences were found regarding in-hospital MACCEs (0.9% vs. 0.9%, p = 0.766), although a higher rate of procedural complications was observed in women, such as coronary perforation (3.7% vs. 2.9%, p < 0.001) and vascular complications (1.0% vs. 0.6%, p < 0.001).
Women are understudied in contemporary CTO-PCI practice. Female sex is associated with higher procedural success after CTO-PCI, yet no sex differences were found in terms of in-hospital MACCEs. Female sex was associated with a higher rate of procedural complications.
We aimed to analyze gender-differences regarding in-hospital clinical outcomes after CTO-PCI.
Data from 35,449 patients enrolled in the prospective European Registry of CTOs were analyzed. The primary outcome was the comparison of procedural success rate in the two cohorts (women vs. men), defined as a final residual stenosis less than 20%, with Thrombolysis In Myocardial Infarction grade flow = 3. In-hospital major adverse cardiac and cerebrovascular events (MACCEs) and procedural complications were deemed secondary outcomes.
Women represented 15.2% of the entire study population. They were older and more likely to have hypertension, diabetes, and renal failure, with an overall lower J-CTO score. Women showed a higher procedural success rate (adjusted OR [aOR] = 1.115, confidence interval [CI]: 1.011-1.230, p = 0.030). Apart from previous myocardial infarction and surgical revascularization, no other significant gender differences were found among predictors of procedural success. Antegrade approach with true-to-true lumen techniques was more commonly used than retrograde approach in females. No gender differences were found regarding in-hospital MACCEs (0.9% vs. 0.9%, p = 0.766), although a higher rate of procedural complications was observed in women, such as coronary perforation (3.7% vs. 2.9%, p < 0.001) and vascular complications (1.0% vs. 0.6%, p < 0.001).
Women are understudied in contemporary CTO-PCI practice. Female sex is associated with higher procedural success after CTO-PCI, yet no sex differences were found in terms of in-hospital MACCEs. Female sex was associated with a higher rate of procedural complications.
摘要：
背景：针对女性患者慢性完全闭塞（CTO）的经皮冠状动脉介入治疗（PCI）的性别特异性数据很少，并且基于小样本量研究。
目的：我们旨在分析CTO-PCI术后院内临床结局的性别差异。
方法：分析了来自前瞻性欧洲CTO注册登记的35,449名患者的数据。主要结果是两个队列中手术成功率的比较(女性与men),定义为最终残余狭窄小于20%，心肌梗死溶栓分级流量=3。院内主要不良心脑血管事件（MACCEs）和手术并发症被认为是次要结果。
结果：女性占整个研究人群的15.2%。他们年龄较大，更有可能患有高血压，糖尿病,肾功能衰竭,J-CTO总体得分较低.女性显示出更高的手术成功率（校正OR[aOR]=1.115，置信区间[CI]：1.011-1.230，p=0.030）。除了以前的心肌梗死和手术血运重建，在手术成功的预测因素中没有发现其他显著的性别差异.在女性中，采用真到真腔技术的顺行方法比逆行方法更常用。在住院MACCE方面没有发现性别差异(0.9%与0.9%，p=0.766),尽管女性手术并发症发生率较高，如冠状动脉穿孔(3.7%vs.2.9%,p<0.001）和血管并发症（1.0%vs.0.6%，p<0.001)。
结论：女性在当代CTO-PCI实践中的研究不足。女性性别与CTO-PCI术后更高的手术成功率相关，但在住院MACCE方面没有发现性别差异。女性与手术并发症的发生率较高有关。
目的：我们旨在分析CTO-PCI术后院内临床结局的性别差异。
方法：分析了来自前瞻性欧洲CTO注册登记的35,449名患者的数据。主要结果是两个队列中手术成功率的比较(女性与men),定义为最终残余狭窄小于20%，心肌梗死溶栓分级流量=3。院内主要不良心脑血管事件（MACCEs）和手术并发症被认为是次要结果。
结果：女性占整个研究人群的15.2%。他们年龄较大，更有可能患有高血压，糖尿病,肾功能衰竭,J-CTO总体得分较低.女性显示出更高的手术成功率（校正OR[aOR]=1.115，置信区间[CI]：1.011-1.230，p=0.030）。除了以前的心肌梗死和手术血运重建，在手术成功的预测因素中没有发现其他显著的性别差异.在女性中，采用真到真腔技术的顺行方法比逆行方法更常用。在住院MACCE方面没有发现性别差异(0.9%与0.9%，p=0.766),尽管女性手术并发症发生率较高，如冠状动脉穿孔(3.7%vs.2.9%,p<0.001）和血管并发症（1.0%vs.0.6%，p<0.001)。
结论：女性在当代CTO-PCI实践中的研究不足。女性性别与CTO-PCI术后更高的手术成功率相关，但在住院MACCE方面没有发现性别差异。女性与手术并发症的发生率较高有关。
