Sex-Specific Outcomes After Coronary Intravascular Lithotripsy: A Patient-Level Analysis of the Disrupt CAD Studies

BackgroundCoronary artery calcification increases the procedural complexity of percutaneous coronary intervention and is associated with worse outcomes, especially in women. Intravascular lithotripsy (IVL) has been demonstrated to be safe effective for vessel preparation severely calcified stenotic lesions before stent implantation. Sex-based outcomes IVL-facilitated stenting have not defined.MethodsWe performed a patient-level pooled analysis 4 prospective, single-arm Disrupt CAD studies that evaluated safety efficacy stenting. Patient baseline characteristics clinical were examined based on sex. The primary end point was 30-day major adverse cardiovascular events, defined as composite cardiac death, myocardial infarction, or target revascularization. success, delivery residual in-stent stenosis вүӨ30% without in-hospital events.ResultsA total 628 patients included, which 144 (22.9%) Women older (P < .001) more likely hyperlipidemia = .03), renal insufficiency .05), prior infarction .05). had smaller mean reference diameter (2.7В вҖӢ ВұВ вҖӢ0.4В вҖӢmm vs 3.0В вҖӢ0.5В вҖӢmm, P .001), shorter lesion length (22.4В вҖӢ10.3В 25.0В вҖӢ11.7В .01), less side branch involvement (22.9% 32.4%, .03). Severe by angiography, predilatation, post-IVL dilatation, poststent dilatation similar between groups. There no significant differences women men (8.3% 7.1%, .61; adjusted odds ratio 1.66; 95% confidence interval 0.78, 3.34; .17) (91.7% 92.6%, .72; 0.58; 0.29, 1.24; .15). Post-IVL serious angiographic complications (flow-limiting dissection, perforation, abrupt closure, slow flow, reflow) (1.6% 2.3%, .75).ConclusionsDespite comorbidities size, achieves men.