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Sex-related differences and rotational atherectomy — analysis of 5 177 percutaneous coronary interventions based on a large national registry from between 2014 and 2020

Karol Sabatowski1, Krzysztof Piotr Malinowski2, Zbigniew Siudak3, Krzysztof Reczuch4, Sławomir Dobrzycki5, Maciej Lesiak6, Michał Hawranek7, Robert Julian Gil8, Adam Witkowski9, Wojciech Wojakowski10, Andrzej Lekston7, Mariusz Gąsior7, Wojciech Wańha10, Jacek Legutko11, Michał Ekkert12, Magdalena Jędrychowska1, Michał Chyrchel113, Andrzej Surdacki112, Stanisław Bartuś113, Rafał Januszek114
DOI: 10.33963/KP.a2021.0131
·
Pubmed: 34643261
Affiliations
  1. Department of Cardiology and Cardiovascular Interventions, University Hospital, Kraków, Poland
  2. Jagiellonian University Medical College, Faculty of Medicine, Department of Bioinformatics and Telemedicine, Kraków, Poland
  3. Faculty of Medicine and Health Sciences, Jan Kochanowski University, Kielce, Poland
  4. Department of Cardiology, 4th Military Hospital, Wrocław, Poland
  5. Department of Invasive Cardiology, State Teaching Hospital, Medical University of Bialystok, Białystok, Poland
  6. 1st Department of Cardiology, Poznan University of Medical Sciences, Poznań, Poland
  7. 3rd Department of Cardiology, Silesian Centre for Heart Diseases in Zabrze, School of Medicine with the Division of Dentistry in Zabrze, Medical University of Silesia in Katowice, Zabrze, Poland
  8. Department of Invasive Cardiology, Centre of Postgraduate Medical Education, Warszawa, Poland
  9. Department of Interventional Cardiology and Angiology, Institute of Cardiology, Warszawa, Poland
  10. Department of Cardiology and Structural Heart Diseases, Medical University of Silesia, Katowice, Poland
  11. Department of Interventional Cardiology, Institute of Cardiology, Jagiellonian University Medical College, John Paul II Hospital, Kraków, Poland
  12. Faculty of Medicine, Katowice School of Technology, Katowice, Poland
  13. Department of Cardiology, Jagiellonian University Medical College, Kraków, Poland
  14. Department of Clinical Rehabilitation, University of Physical Education, Kraków, Poland

open access

Online first
Original article
Published online: 2021-10-11

Abstract

Background: Patients undergoing percutaneous coronary interventions (PCI) with rotational atherectomy (RA) have massively calcified coronary arteries and differ according to sex.
Aims: To assess trends in sex-related percentage shares in following years, to compare demographic characteristics between men and women, and to identify factors associated with the risk of periprocedural complications and death.
Methods: Based on the Polish National Registry of Percutaneous Coronary Interventions (ORPKI), we analyzed 751 113 patients treated with PCI between 2014 and 2020. We extracted 5 177 (0.7%) patients treated with RA, 3 552 of them (68.6%) being men. To determine risk factors of periprocedural complications and death, multivariable analysis was performed.
Results: The proportion of PCIs involving RA increase between 2014 and 2020 (P < 0.001). Almost twice as many RA procedures pertain to men (68.55%), while the percentage share did not change in following years. Data are reported as mean (standard deviation). The female patients were older (75.2 [8.3] vs 70.5 [9.2] years; P < 0.001). When considering periprocedural complications, their overall rate (3.45% vs 2.31%; P = 0.01) and death rate (0.68% vs 0.17%; P = 0.006) were greater among women. Also, via multivariable analysis, female sex was found to be a risk factor of greater periprocedural mortality (P = 0.02) and overall complication rate (P = 0.007).
Conclusions: The majority of patients treated with RA are men and sex-related distribution was stable during the analyzed period of time. Female sex is a risk factor of greater periprocedural complications and mortality in patients treated with RA.

Abstract

Background: Patients undergoing percutaneous coronary interventions (PCI) with rotational atherectomy (RA) have massively calcified coronary arteries and differ according to sex.
Aims: To assess trends in sex-related percentage shares in following years, to compare demographic characteristics between men and women, and to identify factors associated with the risk of periprocedural complications and death.
Methods: Based on the Polish National Registry of Percutaneous Coronary Interventions (ORPKI), we analyzed 751 113 patients treated with PCI between 2014 and 2020. We extracted 5 177 (0.7%) patients treated with RA, 3 552 of them (68.6%) being men. To determine risk factors of periprocedural complications and death, multivariable analysis was performed.
Results: The proportion of PCIs involving RA increase between 2014 and 2020 (P < 0.001). Almost twice as many RA procedures pertain to men (68.55%), while the percentage share did not change in following years. Data are reported as mean (standard deviation). The female patients were older (75.2 [8.3] vs 70.5 [9.2] years; P < 0.001). When considering periprocedural complications, their overall rate (3.45% vs 2.31%; P = 0.01) and death rate (0.68% vs 0.17%; P = 0.006) were greater among women. Also, via multivariable analysis, female sex was found to be a risk factor of greater periprocedural mortality (P = 0.02) and overall complication rate (P = 0.007).
Conclusions: The majority of patients treated with RA are men and sex-related distribution was stable during the analyzed period of time. Female sex is a risk factor of greater periprocedural complications and mortality in patients treated with RA.

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Keywords

complications, mortality, percutaneous coronary intervention, rotational atherectomy, sex

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Title

Sex-related differences and rotational atherectomy — analysis of 5 177 percutaneous coronary interventions based on a large national registry from between 2014 and 2020

Journal

Kardiologia Polska (Polish Heart Journal)

Issue

Online first

Article type

Original article

Published online

2021-10-11

DOI

10.33963/KP.a2021.0131

Pubmed

34643261

Keywords

complications
mortality
percutaneous coronary intervention
rotational atherectomy
sex

Authors

Karol Sabatowski
Krzysztof Piotr Malinowski
Zbigniew Siudak
Krzysztof Reczuch
Sławomir Dobrzycki
Maciej Lesiak
Michał Hawranek
Robert Julian Gil
Adam Witkowski
Wojciech Wojakowski
Andrzej Lekston
Mariusz Gąsior
Wojciech Wańha
Jacek Legutko
Michał Ekkert
Magdalena Jędrychowska
Michał Chyrchel
Andrzej Surdacki
Stanisław Bartuś
Rafał Januszek

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