Despite higher morbity and mortality risk women had similar outcomes and improvement in heart failure as men in complex PCI with impella hemodynamic support
Schreiber T, Htun WW, Kaki A, Dixon S, Blank N, Meraj P, Grines C, O'Neill W. Despite higher morbity and mortality risk women had similar outcomes and improvement in heart failure as men in complex PCI with impella hemodynamic support. J Card Fail. 2017;23(8):S67-S68.
J Card Fail
Background: Sex effect on outcomes in patients undergoing complex high risk percutaneous coronary intervention (PCI) with percutaneous hemodynamicsupport is not well known. Methods: We studied the sex differences in the cVAD Registry, the largest data set to date of patients undergoing complex PCI withthe aid of Impella percutaneous assist devices. Patients without cardiogenic shock who underwent elective or urgent intervention were included. Results: A total of 1053 patients were included in this analysis, 24.8% of which were women. Women were older (72 ± 12 vs. 69 ± 11, P <.001), had more diabetes (59% vs 49%, P =.005), renal insufficiency (35%vs 27%, p = 0,018), valve disease (18% vs 11%, P=.016) and higher STS score (8.21 ± 8 vs 5 ± 6, P <.001). Womenhad less prior CABG than men (19% vs33%, P <.001) and had higher LVEF (33 ± 17vs.28 ± 15, P <.001). There was more left main disease in women and more graft occlusion in men. Women were more likely to undergo multivessel revascularization than men. In hospital mortality, myocardial infarction, stroke and repeat revascularization rates were similar between groups. Both men and womenimproved their EF (28% to 33%, P <.0001 andNYHA class post PCI (71%NYHA Class III and IV to 51% Class IIIand IV,P<.001). Vascular complications were also similar. Women had more bleeding requiring transfusion than men. Conclusion: Women are underrepresented in the overall population undergoing complex supported PCI suggesting that women may encounter a barrier to access to highly specialized medical care. Despite being older and sicker women have similar favorable outcomes asmen, suggesting a mitigating effect of the Impellahemodynamic support during PCI.