| Title |
Sex-specific clinical outcomes after treatment of left main coronary artery disease. A NOBLE substudy / |
| Authors |
McEntegart, Margaret B ; Holm, Niels R ; Lindsay, Martin M ; Oldroyd, Keith G ; Mäkikallio, Timo ; Hildick-Smith, David ; Erglis, Andrejs ; Kellerth, Thomas ; Davidavičius, Giedrius ; Menown, Ian B.A ; Mogensen, Lone J.H ; Nielsen, Per H ; Steigen, Terje K ; Endresen, Petter C ; Spence, Mark S ; Graham, Alastair N.J ; Stradins, Peteris ; Anttila, Vesa ; Thuesen, Leif ; Christiansen, Evald H |
| DOI |
10.1016/j.jscai.2022.100338 |
| Full Text |
|
| Is Part of |
Journal of the Society for Cardiovascular Angiography and Interventions.. Amsterdam : Elsevier B.V.. 2022, vol. 1, iss. 4, art. no. 100338, p. [1-5].. eISSN 2772-9303 |
| Keywords [eng] |
coronary artery bypass surgery ; Female ; left main coronary artery disease ; percutaneous coronary intervention |
| Abstract [eng] |
Background: While female sex has been associated with worse outcomes following coronary revascularization, previous analyses in left main coronary artery (LMCA) disease have been conflicting. In addition, a signal that increased mortality may be specific to women treated with percutaneous coronary intervention (PCI) requires further investigation. Methods: Nordic-Baltic-British left main revascularization study (NOBLE) was a randomized trial comparing PCI to coronary artery bypass surgery (CABG) in patients with LMCA disease. The primary endpoint was a composite of all-cause mortality, nonprocedural myocardial infarction, repeat revascularization, and stroke (major adverse cardiovascular and cerebrovascular events [MACCE]). We report the 5-year sex-specific outcomes. Results: Of 1184 patients analyzed, 256 (22%) were female and 928 (78%) were male. There were no significant within-sex differences in baseline characteristics, disease location, or complexity between those treated with PCI and those with CABG. The 5-year MACCE rates were 29% and 15% in females and 28% and 20% in males treated with PCI and CABG, respectively. Within both sexes, there was an increased risk of MACCE with PCI compared with CABG, but no difference in all-cause mortality. On multivariate analysis, female sex was not an independent predictor of MACCE. Conclusions: Following the treatment of LMCA disease, long-term outcomes favored CABG over PCI in both sexes. Importantly, there was no difference in all-cause mortality in females or males at 5 years. |
| Published |
Amsterdam : Elsevier B.V |
| Type |
Journal article |
| Language |
English |
| Publication date |
2022 |
| CC license |
|
