Circulation, Vol 87, 720-727, Copyright © 1993 by American Heart Association
SF Kelsey, M James, AL Holubkov, R Holubkov, MJ Cowley and KM Detre
BACKGROUND. The National Heart, Lung, and Blood Institute (NHLBI)
Percutaneous Transluminal Coronary Angioplasty (PTCA) 1978-1981 Registry
cohort indicated that PTCA risk was higher and efficacy was lower in women.
Data from the 1985-1986 PTCA Registry are used to address the question of
whether compared with men, women still have a worse outcome after PTCA.
METHODS AND RESULTS. The 1985-1986 NHLBI PTCA Registry collected data on
consecutive, first-PTCA cases at 16 centers. Initial results are reported
for 2,136 patients, 546 of whom were women. Four-year follow-up status was
available on 95% of the cohort. Although women were an average of 4.5 years
older than the male patients and had more cardiovascular risk factors and
more severe angina, their coronary artery disease as assessed by
angiography was not more extensive. Rates of angiographic success on a
per-lesion basis were similar for women and men (89% versus 88%), and the
clinical success rates (79%) were the same. Women had more initial
complications (29% versus 20%, p < 0.001) and a considerably higher
procedural mortality rate (2.6% versus 0.3%, p < 0.001). For patients
who survived the initial procedure, 4-year survival was similar for men and
women. At 4 years, women had slightly fewer events (myocardial infarction,
repeat PTCA, and/or coronary artery bypass grafting). Despite the higher
proportion of women reporting the presence of angina and medication use at
4 years, the proportion reporting improvement in symptomatic status was
similar to that of men. CONCLUSIONS. Women undergoing PTCA have a higher
procedural mortality risk than men; this is explained in part by their
worse cardiovascular risk factor profile. Otherwise, the success rate and
long-term prognosis after PTCA are excellent, and PTCA should be considered
for women in need of revascularization.
ARTICLES
Results of percutaneous transluminal coronary angioplasty in women. 1985-1986 National Heart, Lung, and Blood Institute's Coronary Angioplasty Registry
Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, PA 15261.
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|
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|
|
|
|
|
|
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|
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|
|
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|
|
|
|
 |
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|
|
|
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|
|
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|
|
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|
|
|
|
|
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|
|
|
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|
|
|
|
 |
|
 WOMEN HAVE MORE PROCEDURAL MORTALITY FROM PTCA Journal Watch (General), March 23, 1993; 1993(323): 2 - 2. [Full Text]
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