Yonsei Med J.  2017 Mar;58(2):296-304. 10.3349/ymj.2017.58.2.296.

The Effect of Sex and Anthropometry on Clinical Outcomes in Patients Undergoing Percutaneous Coronary Intervention for Complex Coronary Lesions

• Lee SY
• Shin DH
• Kim JS
• Kim BK
• Ko YG
• Choi D
• Jang Y
• Hong MK

• KMID: 2427117
• DOI: http://doi.org/10.3349/ymj.2017.58.2.296

Abstract

PURPOSE
To evaluate the effects of sex and anthropometry on clinical outcomes in patients who underwent percutaneous coronary intervention (PCI).
MATERIALS AND METHODS
From three randomized trials (REal Safety and Efficacy of 3-month dual antiplatelet Therapy following Endeavor zotarolimus-eluting stent implantation, Impact of intraVascular UltraSound guidance on outcomes of Xience Prime stents in Long lesions, Chronic Total Occlusion InterVention with drUg-eluting Stents), we compared 333 pairs of men and women matched by propensity scores, all of whom underwent intravascular ultrasound (IVUS)-guided PCI for complex lesions.
RESULTS
For 12 months, the incidence of adverse cardiac events, defined as the composite of cardiac death, target lesion-related myocardial infarction, and target lesion revascularization, was not different between women and men (2.4% vs. 2.4%, p=0.939). Using multivariable Cox's regression analysis, post-intervention minimum lumen area [MLA; hazard ratio (HR)=0.620, 95% confidence interval (CI)=0.423-0.909, p=0.014] by IVUS was a predictor of adverse cardiac events. Height on anthropometry and lesions with chronic total occlusion were significantly related to post-intervention MLA. However, female sex was not independently associated with post-intervention MLA. In an age and sex-adjusted model, patients in the low tertile of height exhibited a greater risk for adverse cardiac events than those in the high tertile of height (HR=6.391, 95% CI=1.160-35.206, p=0.033).
CONCLUSION
Sex does not affect clinical outcomes after PCI for complex lesions. PCI outcomes, however, may be adversely affected by height.

Keyword

Coronary artery disease; sex; intravascular ultrasound

MeSH Terms

Aged
*Anthropometry
Coronary Angiography/adverse effects
Coronary Artery Disease/diagnosis/*therapy
Coronary Vessels/diagnostic imaging
Drug-Eluting Stents/*adverse effects
Female
Humans
Incidence
Male
Middle Aged
Myocardial Infarction/epidemiology/etiology
Percutaneous Coronary Intervention/*adverse effects
Propensity Score
Proportional Hazards Models
Sirolimus/administration & dosage/adverse effects/*analogs & derivatives
Time Factors
Treatment Outcome
Ultrasonography, Interventional
Sirolimus

Figure

• 

  Fig. 1 Associations among anthropometric measurements and post-intervention minimum lumen area (MLA) as evaluated by intravascular ultrasound. While height, weight, body surface area, and lean body mass were significantly associated with post-intervention MLA, body mass index and fat mass were not. Black dots indicate women and white dots indicate men.

• 

  Fig. 2 Adjusted event-free survival curve for the composite of cardiac death, target lesion–related myocardial infarction, and ischemia-driven target lesion revascularization, grouped by height tertile. The adjustment included age and sex, and the adjusted hazard ratio (HR) was relative to patients in the high tertile of height. CI, confidence interval.

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