Photo Credit: Atlas Studio
The following is a summary of the “Sex Differences in the Short and Long-term Outcomes Following Rotational Atherectomy: A Meta-analysis,” published in the March 2024 issue of Cardiology by Ang et al.
Rotational atherectomy (RA) serves as a crucial intervention for managing complex calcified coronary lesions, yet its association with gender-specific outcomes remains unclear. This meta-analysis aimed to elucidate the short and long-term outcomes of patients undergoing RA based on sex.
A meticulous, systematic literature search was conducted across PubMed, Embase, and Cochrane databases from inception until August 2023 to identify pertinent studies. Endpoints were synthesized using the DerSimonian and Laird random-effects model, presenting the odds ratio (OR) with corresponding 95% CIs.
The analysis incorporated 7 studies comprising 8,490 patients, among whom 2,565 were women, and 5,925 were men undergoing RA. Regarding periprocedural outcomes, women exhibited a heightened risk of in-hospital mortality (OR 2.00, 95% CI 1.08-3.68, p=0.03), coronary dissection (OR 1.80, 95% CI 1.05-3.10, p=0.03), coronary perforation (OR 1.96, 95% CI 1.19-3.23, p=0.01), and stroke (OR 4.22, 95% CI 1.06-16.82, p=0.04) compared to men. However, no significant differences were observed between genders concerning major adverse cardiac events (MACE), myocardial infarction (MI), bleeding, and cardiac tamponade. Over a 3-year follow-up period, women displayed a higher risk of all-cause mortality (OR 1.45, 95% CI 1.19-1.77, p<0.001), long-term MACE (OR 1.38, 95% CI 1.10-1.74, p=0.01), and long-term stroke (OR 3.41, 95% CI 1.63-7.17, p<0.001). However, the risk of long-term MI did not significantly differ between genders (OR 1.45, 95% CI 0.95-2.22, p=0.09).
This meta-analysis underscores a distinct association between female gender and unfavorable periprocedural and long-term outcomes following RA. Women consistently exhibited elevated risks of in-hospital mortality, coronary complications, and stroke during the periprocedural phase. Moreover, long-term follow-up revealed a sustained heightened risk for women concerning all-cause mortality and stroke.
Source: sciencedirect.com/science/article/abs/pii/S0002914924001929