Geographical Difference of the Interaction of Sex With Treatment Strategy in Patients With Multivessel Disease and Left Main Disease: A Meta-Analysis From SYNTAX (Synergy Between PCI With Taxus and Cardiac Surgery), PRECOMBAT (Bypass Surgery Versus Angioplasty Using Sirolimus-Eluting Stent in Patients With Left Main Coronary Artery Disease), and BEST (Bypass Surgery and Everolimus-Eluting Stent Implantation in the Treatment of Patients With Multivessel Coronary Artery Disease) Randomized Controlled Trials

Circulation. Cardiovascular Interventions
Yohei SotomiPatrick W Serruys

Abstract

The impact of sex on clinical outcomes of percutaneous coronary intervention and coronary artery bypass graft for patients with multivessel coronary disease and unprotected left main disease could be dissimilar between Western and Asian populations. To assess clinical outcomes after percutaneous coronary intervention or coronary artery bypass graft in women and men with multivessel coronary disease and unprotected left main disease, a pooled analysis (n=3280) was performed using the patient-level data from 3 large randomized trials: SYNTAX (Synergy between PCI with Taxus and Cardiac Surgery), PRECOMBAT (Bypass Surgery Versus Angioplasty Using Sirolimus-Eluting Stent in Patients With Left Main Coronary Artery Disease), and BEST (Bypass Surgery and Everolimus-Eluting Stent Implantation in the Treatment of Patients with Multivessel Coronary Artery Disease) trials. The primary end point was all-cause death. Of 3280 patients, 794 patients (24.2%) were women. The median follow-up period was 1806 days (1611-1837 days). In women, a high heterogeneity of the treatment effect among the 3 trials was found for all-cause death (I2>50%), whereas in men, it was consistent across the 3 trials. In the Western trial (SYNTAX), female sex favored ...Continue Reading

References

Feb 21, 2009·The New England Journal of Medicine·Patrick W SerruysUNKNOWN SYNTAX Investigators
Jul 1, 2014·EuroIntervention : Journal of EuroPCR in Collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology·Yoshinobu OnumaUNKNOWN Bern-Rotterdam and j-Cypher registries
Mar 17, 2015·The New England Journal of Medicine·Seung-Jung ParkUNKNOWN BEST Trial Investigators
Mar 20, 2015·Journal of the American College of Cardiology·Jung-Min AhnSeung-Jung Park
Nov 1, 2016·The New England Journal of Medicine·Gregg W StoneUNKNOWN EXCEL Trial Investigators

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Citations

May 13, 2017·Circulation. Cardiovascular Interventions·L Kristin Newby
Oct 28, 2019·EuroIntervention : Journal of EuroPCR in Collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology·Patrick W SerruysYoshinobu Onuma
Jul 9, 2021·The American Journal of Cardiology·Sangwoo ParkUNKNOWN IRIS-MAIN Registry Investigators
Jul 24, 2021·Journal of the American College of Cardiology·Patrick W SerruysSpencer B King Iii
Aug 21, 2020·Journal of the American College of Cardiology·Hironori HaraUNKNOWN SYNTAX Extended Survival Investigators
Nov 16, 2021·Journal of the American Heart Association·Yohei SotomiUNKNOWN Osaka Acute Coronary Insufficiency Study (OACIS) Group

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