Assessment of sex differences in 5-year clinical outcomes following endovascular revascularization for peripheral artery disease

Michael S. Lee, Byoung Geol Choi, John Hollowed, Seung-Kyu Han, Man Jong Baek, Yang gi Ryu, Se Yeon Choi, Jae Kyeong Byun, Ahmed Mashaly, Yoonjee Park, Won Young Jang, Woohyeun Kim, Jah Yeon Choi, Eun Jin Park, Jin Oh Na, Cheol Ung Choi, Eung Ju Kim, Chang Gyu Park, Hong Seog Seo, Seung-Woon Rha

Research output: Contribution to journalArticle

Abstract

Percutaneous transluminal angioplasty (PTA) is an effective treatment strategy for peripheral artery disease (PAD). Data are limiting regarding sex differences in patients with PAD who underwent PTA. We assessed the sex-related differences on 5-year clinical outcomes in patients with PAD who underwent PTA. We prospectively evaluated 765 patients with PAD (596 males and 169 females) who underwent PTA. We performed propensity score matching (PSM) analysis to adjust for any potential confounders. The primary endpoints were 5-year major adverse cardiac and cerebrovascular events (MACE) and major adverse lower-limb events (MALE) assessed by Kaplan-Meier curved analysis and log rank test. After PSM analysis, baseline clinical characteristics were similar in male and female patients. There was a trend toward a higher rate of major hematoma in female patients (6.1% vs. 0.9%, p = 0.066) and a lower rate of below the ankle amputation (24.7% vs. 16.5%, p = 0.097). During the 5-year clinical follow-up, male and female patients had similar rates of MACE (14.9% vs. 15.8%, log rank p = 0.838) and MALE (34.8% vs. 28.2%, log rank p = 0.264) as well as the individual endpoints. In subgroup analysis adjusted by PSM, female patients had a higher risk of bleeding complications in age ≥ 65 years, hypertension, diabetes mellitus, chronic kidney disease, and in the non-critical limb ischemia patients. Of patients with preserved renal function, female patients had a higher risk of MALE as compared to males. In conclusion, female patients with PAD who underwent PTA showed similar 5-year MACE and MALE compared with male patients.

Original languageEnglish
JournalCardiovascular Revascularization Medicine
DOIs
Publication statusPublished - 2019 Jan 1

Fingerprint

Peripheral Arterial Disease
Sex Characteristics
Angioplasty
Propensity Score
Lower Extremity
Kaplan-Meier Estimate
Chronic Renal Insufficiency
Amputation
Ankle
Hematoma
Diabetes Mellitus
Ischemia
Extremities
Hemorrhage

Keywords

  • Clinical outcomes
  • Critical limb ischemia
  • Endovascular therapy
  • Percutaneous transluminal angioplasty
  • Peripheral artery disease
  • Sex

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Assessment of sex differences in 5-year clinical outcomes following endovascular revascularization for peripheral artery disease. / Lee, Michael S.; Choi, Byoung Geol; Hollowed, John; Han, Seung-Kyu; Baek, Man Jong; gi Ryu, Yang; Choi, Se Yeon; Byun, Jae Kyeong; Mashaly, Ahmed; Park, Yoonjee; Jang, Won Young; Kim, Woohyeun; Choi, Jah Yeon; Park, Eun Jin; Na, Jin Oh; Choi, Cheol Ung; Kim, Eung Ju; Park, Chang Gyu; Seo, Hong Seog; Rha, Seung-Woon.

In: Cardiovascular Revascularization Medicine, 01.01.2019.

Research output: Contribution to journalArticle

Lee, Michael S. ; Choi, Byoung Geol ; Hollowed, John ; Han, Seung-Kyu ; Baek, Man Jong ; gi Ryu, Yang ; Choi, Se Yeon ; Byun, Jae Kyeong ; Mashaly, Ahmed ; Park, Yoonjee ; Jang, Won Young ; Kim, Woohyeun ; Choi, Jah Yeon ; Park, Eun Jin ; Na, Jin Oh ; Choi, Cheol Ung ; Kim, Eung Ju ; Park, Chang Gyu ; Seo, Hong Seog ; Rha, Seung-Woon. / Assessment of sex differences in 5-year clinical outcomes following endovascular revascularization for peripheral artery disease. In: Cardiovascular Revascularization Medicine. 2019.
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abstract = "Percutaneous transluminal angioplasty (PTA) is an effective treatment strategy for peripheral artery disease (PAD). Data are limiting regarding sex differences in patients with PAD who underwent PTA. We assessed the sex-related differences on 5-year clinical outcomes in patients with PAD who underwent PTA. We prospectively evaluated 765 patients with PAD (596 males and 169 females) who underwent PTA. We performed propensity score matching (PSM) analysis to adjust for any potential confounders. The primary endpoints were 5-year major adverse cardiac and cerebrovascular events (MACE) and major adverse lower-limb events (MALE) assessed by Kaplan-Meier curved analysis and log rank test. After PSM analysis, baseline clinical characteristics were similar in male and female patients. There was a trend toward a higher rate of major hematoma in female patients (6.1{\%} vs. 0.9{\%}, p = 0.066) and a lower rate of below the ankle amputation (24.7{\%} vs. 16.5{\%}, p = 0.097). During the 5-year clinical follow-up, male and female patients had similar rates of MACE (14.9{\%} vs. 15.8{\%}, log rank p = 0.838) and MALE (34.8{\%} vs. 28.2{\%}, log rank p = 0.264) as well as the individual endpoints. In subgroup analysis adjusted by PSM, female patients had a higher risk of bleeding complications in age ≥ 65 years, hypertension, diabetes mellitus, chronic kidney disease, and in the non-critical limb ischemia patients. Of patients with preserved renal function, female patients had a higher risk of MALE as compared to males. In conclusion, female patients with PAD who underwent PTA showed similar 5-year MACE and MALE compared with male patients.",
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AU - Baek, Man Jong

AU - gi Ryu, Yang

AU - Choi, Se Yeon

AU - Byun, Jae Kyeong

AU - Mashaly, Ahmed

AU - Park, Yoonjee

AU - Jang, Won Young

AU - Kim, Woohyeun

AU - Choi, Jah Yeon

AU - Park, Eun Jin

AU - Na, Jin Oh

AU - Choi, Cheol Ung

AU - Kim, Eung Ju

AU - Park, Chang Gyu

AU - Seo, Hong Seog

AU - Rha, Seung-Woon

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