J Cardiovasc Interv.  2024 Apr;3(2):72-84. 10.54912/jci.2023.0019.

Sex Differenced in Diastolic Function and Long-term Clinical Outcomes in Patient With Peripheral Artery Disease Who Underwent Percutaneous Transluminal Angioplasty: Single Center, Cohort Study

• Kim KH
• Choi BG
• Rha SW

• KMID: 2560962
• DOI: http://doi.org/10.54912/jci.2023.0019

Abstract

Background
Sex-based disparities in peripheral arterial disease (PAD) outcomes are not well-understood. This study investigates whether there are differences in long-term clinical outcomes between sexes in PAD patients undergoing percutaneous transluminal angioplasty (PTA). We hypothesized that women patients with PAD undergoing PTA have higher degrees of diastolic dysfunction and experience more adverse outcomes.
Methods
In a single-center prospective registry, the outcomes of 786 consecutive patients (176 women, 22%) who underwent PTA for symptomatic PAD stratified by gender was analyzed. All registered patients had an ejection fraction greater than 50%. Echocardiographic and clinical parameters were tested using stepwise logistic regression analysis to determine independent predictors of 5-year mortality.
Results
Women had higher E/e’ than men (16.1 ± 6.2 vs. 12.3 ± 4.9, P < 0.001) and higher left ventricular diastolic dysfunction (35% women vs. 26% men, P < 0.001). Women had diastolic dysfunction were older (age > 70 years), hypertension, diabetes mellitus, and chronic kidney disease. After multivariable adjustment, diastolic dysfunction and age were strong predictor of total mortality. However no significant differences were observed between women and men for binary restenosis at 1 year and clinical events including survival at 5 years.
Conclusions
While diastolic dysfunction emerged as a significant predictor of poorer prognosis in PAD patients post-PTA, our findings indicate that sex does not significantly affect long-term outcomes, including restenosis and 5-year survival. This highlights the importance of individualized treatment approaches based on specific clinical characteristics rather than sex differences alone.

Keyword

Diastolic function; Percutaneous transluminal angioplasty; Sex differences