SEX DIFFERENCES IN HIGH-RISK BUT INDICATED CORONARY INTERVENTIONS. NATIONAL REPORT FROM THE BRITISH CARDIOVASCULAR INTERVENTION SOCIETY REGISTRY

Background: Complex and high-risk but indicated percutaneous coronary intervention (CHiP) is increasingly common in contemporary PCI practice. Data on sex differences in the type of CHiP procedures undertaken or their associated clinical outcomes are limited. Methods: Patients with stable angina who underwent CHiP between 1st January 2006 and 31st December 2017 were included. All procedures were stratified by sex. Multivariate logistic regression analyses were performed to investigate the sex-specific odds ratios (aOR) of in-hospital outcomes. Results: Out of 424,290 PCI procedures, 141,610 (33.37%) were CHiP. Overall, 32,129 (23%) of CHiP were undertaken in females. Females were older than males (median 74.8 years vs 69.1 years). Males had a higher prevalence of previous MI (44.6% vs 35.6%) and previous PCI (40% vs 32.5%). The most common variable observed in female patients was age>80 (35.4%), followed by prior CABG (24.3%) and severe coronary calcifications (22.6%). In contrast, in males, it was CABG (36%), followed by CTO PCI (34% and severe calcifications (22%). Females had higher odds for mortality [aOR 1.78 95%CI (1.4, 2.2)], bleeding [aOR 1.99 95%CI (1.72, 3.2)], and major adverse cardiovascular and cerebral events [aOR 1.23 95%CI (1.09, 1.38)] compared to males. Conclusion: In this national analysis of CHIP procedures over 12 years, there were significant differences in the type of CHiP procedures undertaken, with females at increased odds for mortality and in-hospital adverse outcomes