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Clinical research

Effect of gender differences on early and mid-term clinical outcome after percutaneous or surgical coronary revascularisation in patients with multivessel coronary artery disease: Insights from ARTS I and ARTS II

1. First Department of Cardiology, Athens Medical School, Athens, Greece; 2. Onassis Cardiac Surgery Center, Athens, Greece; 3. Institut Cardiovasculaire Paris Sud, Massy, France; 4. Onze Lieve Vrouw Ziekenhuis, Aalst, Belgium; 5. San Raffaele Hospital, Milan, Italy; 6. Hospital Clinico San Carlos, Madrid, Spain; 7. Segeberger Kliniken GmbH, Bad Segeberg, Germany; 8. Clinique Pasteur, Toulouse, France; 9. Kerckhof-Klinik, Bad Nauheim, Germany; 10. Cardialysis B. V., Rotterdam, The Netherlands; 11. Cordis Clinical Research EMAE, Waterloo, Belgium; 12. Thoraxcenter, Rotterdam, The Netherlands

Aims: The aim of the current study was to compare the short and mid-term outcome between males and females treated with percutaneous coronary intervention (PCI) with bare metal stent implantation or coronary artery bypass graft (CABG) surgery and drug-eluting stent implantation in the Arterial Revascularisation Therapies Study I and II (ARTS I and II).

Methods and Results: The patients included in ARTS I were randomised to PCI with bare metal stents or to CABG. The patients enrolled in ARTS II were treated with Cypherâ„¢ stent implantation. All patients were scheduled for clinical follow-up at one, six and twelve months, and after three and five years. Major adverse cardiac and cerebrovascular events (MACCE) included death, cerebrovascular accident (CVA), myocardial infarction (MI), repeat target vessel PCI (RPCI) and CABG. At one and three-year follow-up in ARTS II, both the female and male patients had an incidence of MACCE similar to ARTS I-CABG. When comparing the female and male population of ARTS II, there were no differences between the two genders in terms of in-hospital outcome. At one year and three years there were no gender specific differences in the incidence of MACCE.

Conclusions: Female and male patients in ARTS II had significantly lower MACCE rates compared with ARTS I-PCI, but similar to that of ARTS I-CABG. In ARTS II, MACCE free survival was similar for the two genders at three years follow-up.

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