Does gender influence long-term results of coronary angioplasty in multivessel disease?

Multivessel coronary angioplasty, defined as angioplasty of 2 or 3 main coronary vessels performed during the same procedure, was performed in 203 selected patients between 1981 and 1986. The results in men (n = 159, group I) were compared with those in women (n = 44, group II). The angiographic appearances were comparable in the two groups, but the women were older, more often hypertensive and diabetic, and more symptomatic than the men (82 % vs 57 % in grades 3 or 4 of the Canadian Cardiovascular Society (CCS) Classification; p < 0.009). Complete revascularisation with angioplasty of all stenoses > 50 % was attempted during the same session. The primary success rate per lesion was comparable in the two groups (90 % in men, 93 % in women; NS), as was the number of segments successfully dilated per patient (2.2 +/- 0.7 in group 1 and 2.2 +/- 0.8 group II: NS). Angioplasty was complicated by myocardial infarction and/or emergency coronary bypass surgery in 11 men and 2 women (NS). Clinical followup was obtained for an average of 71 +/- 22 months in the men and 70 +/- 22 months in the women in 96 % of cases. The global seven year survival rate without recurrent infarction or cardiovascular death was 81 % in men and 83 % in women (NS). The number of repeat revascularisation procedures was comparable in the two groups (46 % in women and 43 % in men; NS) as was the number and duration of hospital admissions during follow-up (8.4 +/- 12.3 days in the women and 6.7 +/- 8.4 days in the men; NS). The functional status at the end of follow-up was the same in the two groups with 84 % of men and 81 % of women being asymptomatic or grade 1 of the CCS classification. The authors conclude that the long-term results of multivessel angioplasty are good and comparable in men and women. This revascularisation procedure should be considered as an alternative to surgery in women and men.