Sex-Specific Differences in Clinical Outcomes in Patients With Coronary Bifurcation Lesions

Abstract

Coronary bifurcation lesions are frequent challenging findings during percutaneous coronary intervention (PCI). Contemporary evidence has explored the potential sex-specific differences in patients undergoing PCI. In the present meta-analysis, we compared clinical outcomes of patients undergoing bifurcation PCI between women and men. Using the random-effects method, we compared the clinical outcomes of patients with a coronary bifurcation lesion following PCI between women and men. The results were reported using relative risk (RR) and 95% confidence interval (CI). Baseline comorbidities and mean age were compared between the 2 studied groups. Four observational studies comprising 30,684 patients (8898 women and 21,786 men) were included in the meta-analysis. Women were significantly older than men with a relatively higher prevalence of baseline comorbidities. After using adjusted data from 2 out of 4 available studies, performing PCI for bifurcation lesions in women was not associated with an increased risk of mortality (RR 1.33, 95% CI, 0.78–2.29), myocardial infarction (RR 1.22, 95% CI, 0.41–3.61), target lesion revascularization (RR 1.06, 95% CI, 0.40–2.81), stent thrombosis (RR 0.99, 95% CI, 0.09–10.52), and stroke (RR 1.19, 95% CI, 0.64–2.22). Women were at higher risk of major bleeding compared to male counterparts (RR 2.23, 95% CI, 1.73–2.89). The present study showed no difference in the risk of adverse clinical outcomes except the risk of bleeding between genders with coronary bifurcation lesions. Future studies with adjustment of age and baseline comorbidities are needed to confirm these findings.