Age and gender differences in clinical outcomes of patients with heavy-calcified coronary artery lesions treated percutaneously with rotational atherectomy

Abstract

Background. Rotational atherectomy (RA) used in elderly patients treated with percutaneous coronary interventions (PCI) could enable revascularization or the omission of cardiac surgery. Knowledge about factors affecting the prognosis may improve the results of treatment. Objectives. We aimed to assess the relationship of gender and age with long-term clinical outcomes expressed as major adverse cardiac and cerebrovascular events (MACCEs). Material and methods. The study included 97 consecutive patients treated with PCI and RA at the mean age of 71. The study group contained 73.2% men and 26.8% women, 36.1% of patients older than 75 and 63.9% younger than 75. The mean time of follow-up was 695.3 ±560.9 days. The rate of MACCEs (deaths, myocardial infarctions (MIs), reinterventions, coronary artery by-pass surgeries, or cerebral strokes (CSs)/transient ischemic attacks (TIAs)) in the overall group of patients was calculated at 33.7%.Results. The comparison of Kaplan-Meier survival curves did not depict significant differences in the frequency of MACCEs for age (p = 0.36) and gender (p = 0.07). We noticed that the death rate was higher in females than in males and in patients older than 75 compared to those younger, and was statistically significant for age (p = 0.04). The rate of periprocedural complications was significantly higher among women than among men (p = 0.005) and in patients older than 75 compared to the younger ones (p = 0.003). Conclusions. Age and gender are not significantly associated with an increased rate of MACCEs during follow-up in elderly patients treated with PCI and RA.