TCT-384 Sex-Based Analysis of Acute Outcomes Post-Orbital Atherectomy for Severely Calcified Coronary Lesions
Recommended Citation
Mandava S, Ghazzal A, Torres C, Vedantam K, Igyarto Z, Martinsen B, Kirtane A, Leon M, Beohar N. TCT-384 Sex-Based Analysis of Acute Outcomes Post-Orbital Atherectomy for Severely Calcified Coronary Lesions. J Am Coll Cardiol 2024; 84(18):B105.
Document Type
Conference Proceeding
Publication Date
10-29-2024
Publication Title
J Am Coll Cardiol
Abstract
Background: Limited research exists on the safety and effectiveness of coronary orbital atherectomy (OA) in women vs men, with prior studies suggesting higher rates of complications in women. This single-center analysis aimed to provide a sex-based comparison using real-world data. Methods: Retrospective analysis was conducted on consecutive patients treated with coronary OA for severely calcified lesions at the Mount Sinai Medical Center, Miami Beach, Florida, from January 2014 to September 2020. Severe angiographic complications, bleeding events, in-hospital heart failure, cardiogenic shock, and major adverse and cardiac cerebrovascular events (MACCE) comprised of cardiac death, myocardial infarction (MI), ischemic cerebrovascular accident (CVA), and hemorrhagic CVA were assessed. Results: Among 609 patients undergoing percutaneous coronary intervention (PCI) with OA, 36% were women and 64% were men, with median ages of 77 and 73 years, respectively. Women exhibited a significantly higher prevalence of Hispanic, Black, or Indigenous ethnicity all with P < 0.05, as well as more frequent right coronary artery target vessels (32.6% vs 19.3%; P < 0.001). They also had significantly lower rates of smoking, MI, and coronary artery bypass grafting all with P < 0.05. No significant sex differences were observed in severe angiographic complications, bleeding events, or in-hospital MACCE. However, heart failure post-PCI was significantly more common among women (1.4% vs 0%; P = 0.048). Conclusion: Contrary to previous clinical trial findings, this real-world analysis suggests that women undergoing OA have similar rates of severe angiographic complications and in-hospital MACCE as men. The higher incidence of post-PCI heart failure in women warrants further investigation. Categories: CORONARY: Coronary Atherectomy, Plaque Modification, Lithotripsy, Thrombectomy, Cutting/Scoring Balloons.
Volume
84
Issue
18
First Page
B105
