Sex-Based Differences in Clinical Characteristics and Outcomes Among Patients with Peripheral Artery Disease: A Retrospective Analysis

Abstract

Peripheral arterial disease (PAD) is a prevalent medical condition associated with high mortality and morbidity rates. Despite the high clinical burden, sex-based differences among PAD patients are not well defined yet, in contrast to other atherosclerotic diseases. This study aimed to describe sex-based differences in clinical characteristics and outcomes among hospitalized patients affected by PAD. This was a retrospective study evaluating all patients with a diagnosis of PAD admitted to the Emergency Department. The primary endpoint of the study was the difference between male and female PAD patients in cumulative occurrence of a Major Acute Cardiovascular Event (MACE) and of a Major Acute Limb Events (MALE). A total of 1640 patients were enrolled. Among them, 1103 (67,3%) were males while females were significantly older (median age of 75 years vs 71 years). Females underwent more angioplasty treatments for revascularization than men (29.8% vs 25.6%); males were treated mostly with amputations (19.9 % vs 15.3%). Although MALE and MACE events were more commonly reported in the male group, there was not a statistically significant gender related-difference (OR 1.27 [0.99 – 1.64]; p=0.059) (OR 0.75 [0.50 – 1.11] p=0.153). However, despite lower extremity PAD severity seeming similar between the two sexes, among these patients males had a higher probability of undergoing lower limb amputations, of cardiovascular death and of myocardial infarction. Among hospitalized patients affected by PAD, even if there was not a sex-based significant difference in the incidence of MALE and MACE, adverse clinical outcomes were more common in males.