Is sex associated with adverse outcomes after percutaneous coronary intervention for CTO?

Background: Conflicting results have been reported regarding sex differences in percutaneous coronary intervention (PCI), but their potential influence on clinical outcomes after chronic total coronary occlusion (CTO) PCI remains unknown. We aimed to identify sex-related differences in long-term clinical outcomes after CTO PCI. Methods and results: All consecutive patients undergoing CTOPCI between 2004 and 2012were included in a prospective registry. Baseline, procedural characteristics and clinical outcomeswere compared according to sex. Out of 1343 patients, 194 were female (14.4%). Womenwere older (68.5 +/- 9.9 vs 62.3 +/- 10.8 years, p < 0.001), more frequently diabetic (33.5% vs 26.4%, p=0.026) and hypertensive (70.1% vs 57.4%, p < 0,001), whereasmaleswere more frequently smokers (28.5% vs 15.5%, p < 0.001). J-CTO scorewas similar between both sexes (1.59 +/- 0.91 vs 1.51 +/- 0.88). The procedural success rate was also similar inmen and women (74.0% vs 77.3%, respectively). At 8 years' follow-up, successful CTO PCI was associated with reduced mortality in women (14.8% vs 36.2%, p = 0.003) andmen (18.5% vs 29.1%, p < 0.001). In successful CTO PCI cases, no sex-related differenceswere observed in terms of major adverse cardiac events. Conclusions: Our study suggests an equal benefit of CTO interventionswith a marked reduction inmortality after successful CTO PCI in women and men alike. (c) 2019 Elsevier B. V. All rights reserved.