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Does Gender Affect the Outcomes of Myocardial Revascularization for Left-Main Coronary Artery Disease?

Amin DaoulahNezar Essam Elsheikh-MohamedNooraldaem YousifAhmad S HersiAhmad W AlharbiWael AlmahmeedMohammed AlshehriBadr AlzahraniAmir ElfarnawanyAbdulaziz AlasmariReda AbuelattaTurki Al GarniMohamed Ajaz GhaniHaitham AminShahrukh HashmaniFaisal Omar M Al NasserNiranjan HiremathAmr A ArafatYoussef ElmahroukHameedullah M KazimWael A RefaatEhab SelimAhmed JamjoomOsama El-SayedZiad DahdouhJairam AithalAhmed M IbrahimAbdelmaksoud ElganadyMohammed A QutubMohamed N AlamaAbdulwali AbohasanTaher HassanMohammed BalghithAdnan Fathey HussienIbrahim A M AbdulhabeebOsama AhmadMohamed RamadanAbdulrahman H AlqahtaniWael QenawiAhmed ShawkyAhmed A GhonimAhmed Farid ElmahroukMaryam Jameel NaserMohammed AbozenahAbeer M ShawkyAbdulrahman M AlqahtaniRuqayyah Ali AhmedAhmed F AbdelazizSameer AlhamidAmir Lotfi
Published in: Angiology (2023)
Currently, gender is not considered in the choice of the revascularization strategy for patients with unprotected left main coronary artery (ULMCA) disease. This study analyzed the effect of gender on the outcomes of percutaneous coronary intervention (PCI) vs coronary artery bypass grafting (CABG) in patients with ULMCA disease. Females who had PCI (n = 328) were compared with females who had CABG (n = 132) and PCI in males (n = 894) was compared with CABG (n = 784). Females with CABG had higher overall hospital mortality and major adverse cardiovascular events (MACE) than females with PCI. Male patients with CABG had higher MACE; however, mortality did not differ between males with CABG vs PCI. In female patients, follow-up mortality was significantly higher in CABG patients, and target lesion revascularization was higher in patients with PCI. Male patients had no difference in mortality and MACE between groups; however, MI was higher with CABG, and congestive heart failure was higher with PCI. In conclusion, women with ULMCA disease treated with PCI could have better survival with lower MACE compared with CABG. These differences were not evident in males treated with either CABG or PCI. PCI could be the preferred revascularization strategy in women with ULMCA disease.
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