Effect of Sex on Outcomes of Coronary Rotational Atherectomy Percutaneous Coronary Intervention (From the European Multicenter Euro4C Registry).


Bouisset F(1), Ribichini F(2), Bataille V(3), Reczuch K(4), Dobrzycki S(5), Meyer-Gessner M(6), Bressollette E(7), Zajdel W(8), Faurie B(9), Mezilis N(10), Palazuelos J(11), Spedicato L(12), Valdés M(13), Vaquerizo B(14), Ferenc M(15), Cayla G(16), Barbato E(17), Carrié D(3); Euro4C Registry Investigators.
Author information:
(1)Department of Cardiology, Rangueil Toulouse University Hospital, University Paul Sabatier, Toulouse, France. Electronic address: [Email]
(2)Division of Cardiology, University of Verona, Italy.
(3)Department of Cardiology, Rangueil Toulouse University Hospital, University Paul Sabatier, Toulouse, France.
(4)Department of Heart Diseases, Wroclaw Medical University, Wrocław, Poland.
(5)Department of Invasive Cardiology, State Teaching Hospital, Medical University of Bialystok, Bialystok, Poland.
(6)Augusta Krankenhaus, Düsseldorf, Germany.
(7)Nouvelles cliniques Nantaises, Nantes, France.
(8)Department of Interventional Cardiology, Institute of Cardiology, Jagiellonian University Medical College, John Paul II Hospital, Kraków, Poland.
(9)Cardiovascular Institute, Groupe Hospitalier Mutualiste, Grenoble, France.
(10)Department of Cardiology, St Luke's Hospital, Thessaloniki, Greece.
(11)Department of Cardiology, Hospital Universitario Central de la Defensa Gómez Ulla, Madrid, Spain.
(12)Division of Cardiology, Udine University Hospital, Udine, Italy.
(13)Department of Cardiology, University Hospital Virgen Arrtixaca, Murcia, Spain.
(14)Unidad de Cardiología Intervencionista, Hospital del Mar, Universidad Autónoma de Barcelona, Barcelona, Spain.
(15)Department of Cardiology and Angiology II, University Heart Center Freiburg-Bad Krozingen, Bad Krozingen, Germany.
(16)Department of Cardiology, Centre Hospitalier Universitaire de Nîmes, Université de Montpellier, Nimes, France.
(17)Division of Cardiology, Department of Advanced Biomedical Sciences, University Federico II, Naples, Italy.


Data regarding the potential influence of gender on outcomes of rotational atherectomy (RA) percutaneous coronary intervention (PCI) are scarce and conflicting. Using the Euro4C registry, an international prospective multicentric registry of RA PCI, we evaluated the influence of gender on clinical outcomes of RA PCI. Between October 2016 and July 2018, 966 patients were included. In them, 267 (27.6%) were females. Female patients were older than males (77.7 years old ± 9.8 vs 73.3 ± 9.5 years old respectively, p < 0.001) had a poorer renal function (43,1% of females had a GFR < 60 ml/min:1.73m² vs 30.4% of males, p < 0.001) and were more frequently admitted for an acute coronary syndrome (32.2% vs 22.3% p = 0.002). During RA procedure, women were less likely to be treated by radial approach (65.0% vs 74.4%, p = 0.004). In-hospital major adverse cardiac event rate-defined as cardiovascular death, myocardial infarction, stroke/transient ischemic attack, target lesion revascularization, and coronary artery bypass grafting surgery-was higher in the female group (7.1% vs 3.7%, p = 0.043). However, coronary perforation, dissection, slow/low flow and tamponade did not significantly differ in gender, neither did cardiovascular medications at discharge. At 1 year follow-up, rate of major adverse cardiac event was 18.4% in the female group vs 11.2% in the male group (adjusted Hazard Ratio 1.82 [1.24 to 2.67], p = 0.002). No significant bleeding differences were observed in gender, neither in hospital, nor during follow-up. In conclusion women had worse clinical outcomes following RA PCI during hospitalization and at 1 year follow-up than did men.