Elizabeth A Jackson1, Khan Munir1, Theodore Schreiber2, Jeffrey R Rubin3, Robert Cuff4, Katherine A Gallagher5, Peter K Henke5, Hitinder S Gurm1, P Michael Grossman6. 1. Department of Internal Medicine, Division of Cardiovascular Medicine, University of Michigan Health System, Ann Arbor, Michigan. 2. Department of Internal Medicine, Division of Cardiovascular Medicine, Detroit Medical Center and Wayne State University School of Medicine, Detroit, Michigan. 3. Department of Vascular Surgery, Detroit Medical Center and Wayne State University School of Medicine, Detroit, Michigan. 4. Division of Vascular Surgery, Spectrum Health Medical Group, Grand Rapids, Michigan. 5. Department of Surgery, Division of Vascular Surgery, University of Michigan Health System, Ann Arbor, Michigan. 6. Department of Internal Medicine, Division of Cardiovascular Medicine, University of Michigan Health System, Ann Arbor, Michigan. Electronic address: pagross@umich.edu.
Abstract
OBJECTIVES: This study sought to examine sex-related differences in outcomes related to peripheral vascular intervention (PVI) procedures. BACKGROUND: Percutaneous PVI is frequently performed for the treatment of peripheral arterial disease (PAD). However, little is known about sex-related differences related to PVI procedures. METHODS: We assessed the impact of sex among 12,379 patients (41% female) who underwent lower extremity (LE)-PVI from 2004 to 2009 at 16 hospitals participating in the Blue Cross Blue Shield of Michigan Cardiovascular Consortium PVI registry. Multivariate propensity-matched analyses were performed to adjust for differences in baseline characteristics, procedural indications, and comorbidities on the basis of sex. RESULTS: Compared with men, women were older and have multilevel disease and critical limb ischemia. In a propensity-matched analysis, female sex was associated with a higher rate of vascular complications, transfusions, and embolism. No differences were observed for in-hospital death, myocardial infarction, or stroke or transient ischemic attack. Technical success was more commonly achieved in women (91.2% vs. 89.1%, p = 0.014), but because of a higher complication rate, the overall procedural success rates were similar in men and women (79.7% vs. 81.6%, p = 0.08). CONCLUSIONS: Women represent a significant proportion of patients undergoing LE-PVI, have a more severe and complex disease process, and are at increased risk for adverse outcomes. Despite higher complications rates, women had similar procedural success compared with men, making PVI an effective treatment strategy among women with LE-PAD.
OBJECTIVES: This study sought to examine sex-related differences in outcomes related to peripheral vascular intervention (PVI) procedures. BACKGROUND: Percutaneous PVI is frequently performed for the treatment of peripheral arterial disease (PAD). However, little is known about sex-related differences related to PVI procedures. METHODS: We assessed the impact of sex among 12,379 patients (41% female) who underwent lower extremity (LE)-PVI from 2004 to 2009 at 16 hospitals participating in the Blue Cross Blue Shield of Michigan Cardiovascular Consortium PVI registry. Multivariate propensity-matched analyses were performed to adjust for differences in baseline characteristics, procedural indications, and comorbidities on the basis of sex. RESULTS: Compared with men, women were older and have multilevel disease and critical limb ischemia. In a propensity-matched analysis, female sex was associated with a higher rate of vascular complications, transfusions, and embolism. No differences were observed for in-hospital death, myocardial infarction, or stroke or transient ischemic attack. Technical success was more commonly achieved in women (91.2% vs. 89.1%, p = 0.014), but because of a higher complication rate, the overall procedural success rates were similar in men and women (79.7% vs. 81.6%, p = 0.08). CONCLUSIONS:Women represent a significant proportion of patients undergoing LE-PVI, have a more severe and complex disease process, and are at increased risk for adverse outcomes. Despite higher complications rates, women had similar procedural success compared with men, making PVI an effective treatment strategy among women with LE-PAD.
Authors: Bhaskar Bhardwaj; John A Spertus; Kevin F Kennedy; W Schuyler Jones; David Safley; Thomas T Tsai; Herbert D Aronow; Amit N Vora; Yashashwi Pokharel; Arun Kumar; Robert R Attaran; Dmitriy N Feldman; Ehrin Armstrong; Anand Prasad; Bruce Gray; Adam C Salisbury Journal: JACC Cardiovasc Interv Date: 2019-06-24 Impact factor: 11.195
Authors: Caitlin W Hicks; Ning Ding; Lucia Kwak; Shoshana H Ballew; Corey A Kalbaugh; Aaron R Folsom; Gerardo Heiss; Josef Coresh; James H Black; Elizabeth Selvin; Kunihiro Matsushita Journal: Atherosclerosis Date: 2021-03-29 Impact factor: 5.162