Gender-Based Long-Term Outcomes After Revascularization for Three-Vessel Coronary Disease: A Propensity Score-Matched Analysis of a Large Cohort

Abstract

Objective To investigate the impact of gender on long-term outcomes after revascularization in patients with three-vessel disease (TVD), a severe and challenging subtype of coronary artery disease. Methods This was a single center retrospective cohort study. A total of 3776 patients with TVD who underwent revascularization between 2013 and 2018 were analyzed and were divided into the female group (n = 1039, 27.5%) and the male group (n = 2737, 72.5%). We performed a 1:2 propensity score matching (PSM) to balance the baseline characteristics, and a total of 1506 (504 matched pairs) patients were created after undertaking PSM. The primary outcome was the frequency of major adverse cardiac and cerebrovascular events (MACCE) including all-cause death, myocardial infarction, repeat revascularization, stroke, and readmission for angina pectoris or heart failure. The secondary outcome was the incidence of all-cause death. Results Through 2.4-year follow-up, no significant differences in MACCE (25.8% vs 27.5%, p = 0.279) and all-cause death (2.1% vs 2.2%, p = 0.888) were observed between the two cohorts. Similar results as with the early detection were obtained in propensity-matched patients. Multivariable analysis revealed that female gender (hazard ratio 0.99, 95% confidence interval 0.88–1.17, p = 0.820) was not an independent predictor of MACCE but percutaneous coronary intervention (compared with coronary artery bypass graft surgery), hypertension, diabetes mellitus, atrial fibrillation, left main trunk involvement and left ventricular ejection fraction ≤40% were independently associated with a higher MACCE rate in these patients. Conclusion For patients with TVD after coronary revascularization, there were no gender-based differences in the long-term outcomes and female gender was not an independent predictor of MACCE.

Systemic Immune-Inflammation Index Predicts Long-Term Outcomes in Patients with Three-Vessel Coronary Disease After Revascularization: Results from a Large Cohort of 3561 Patients

“…1 TVD Patients are at the highest risk for cardiovascular adverse events in CAD. 2 Revascularization has been found to lead to long-term benefits among TVD patients. 3 Scientific evidence has depicted that inflammation plays an important role in atherosclerotic CAD pathogenesis.…”

Prognostic Value of Fibrinogen-to-Albumin Ratio in Coronary Three-Vessel Disease

“…2 The inflammatory state of patients with three-vessel disease is more prominent when compared with that of single-vessel disease. 3 In addition, the risk of mortality in patients with three-vessel disease is almost twice as high as in patients with single-vessel disease and is an independent predictor of adverse clinical outcomes compared to single-vessel disease. 4 Fibrinogen, a plasma protein produced by the liver, is an indicator of thrombotic status and plays a role in inflammatory processes of varying degrees of severity.…”