P3589Outcome of women compared with men in patients undergoing complex percutaneous coronary intervention with hemodynamic support

Abstract

Background: The impact of gender on patient outcome who are undergoing high risk percutaneous coronary intervention (HRPCI) with percutaneous hemodynamic support is not well known. We sought to study the outcome of HRPCI in men compared with women. Methods: We studied the sex differences in the cVAD Registry, the largest data set of patients undergoing HRPCI with hemodynamic support using Impella percutaneous assist devices. Patients without cardiogenic shock who underwent elective or urgent intervention were included. We excluded al patients who presented with shock. Results: A total of 1,053 patients were included in this analysis, 24.8% of which were women. Women were older (72±12 vs. 69±11, p<0.001), had higher rate of diabetes (59% vs 49%, p=0.005), renal insufficiency (35%vs 27%, p=0,018), valvular heart disease (18% vs 11%, p=0.016) and higher STS score (8.21±8 vs 5±6, P<0.001) compared to men. Women had less prior CABG surgery than men (19% vs 33%, p<0.001) and had higher LVEF (33±17 vs. 28±15, p<0.001) at the time of procedure. There was more left main disease in women and more graft occlusion in men. Women were more likely to undergo multivessel revascularization than men. There was no difference between women and men in regard to in-hospital mortality, myocardial infarction, stroke, vascular complications were also similar or repeat revascularization rates. Both groups improved their EF (28% to 33%, p<0.0001 and NYHA class post PCI (71% NYHA Class III and IV to 51% Class III and IV, p<0.001). However, bleeding which requires blood transfusion was higher in women compared with men. Conclusion: Similar to other studies, women continue to be underrepresented in the overall population undergoing HRPCI assisted with mechanical circulatory support using Impella device. Although presenting with higher comorbidities for HRPCI, women have similar favorable outcomes as men. This suggesting that women continue to encounter a barrier to access to highly specialized medical care. (Table Presented).