The Impact of Gender on In-hospital Outcomes after Carotid Endarterectomy or Stenting

Bisdas T, Egorova N, Moskowitz AJ, et al (Mount Sinai Med School, NY; et al) Eur J Vasc Endovasc Surg 44:244-250, 2012^§

Abstract

Aim

We sought to better define the impact of sex on ‘in-hospital outcomes’ after carotid endarterectomy (CEA) or stenting (CAS).

Methods

Hospital discharge databases for all carotid interventions obtained from the New York State (NYS) Department of Health, Statewide Planning and Research Cooperative System between 2000 and 2009 (29,917 women, 39,771 men) were analysed. Mortality, stroke and composite event (stroke/death) were compared between procedures after matching of patients by propensity score. Acute myocardial infarction (AMI) was our secondary ‘end’ point.

Results

More than 90% of patients in both sexes were asymptomatic (27,439 women and 36,295 men). Compared to men, asymptomatic women experienced more strokes after CEA (women: 1.38%, men: 1.16%, P = 0.03) and higher AMI rates after both procedures (CEA; women: 0.75%, men: 0.51%, P = 0.0009, CAS; women: 0.96%, men: 0.28%, P = 0.01). Between procedures, symptomatic women undergoing CAS showed higher rates of mortality (CAS: 4.19%, CEA: 0.47%, P = 0.01) and combined (stroke/mortality) events (CAS: 12.09%, CEA: 6.05%, P = 0.02). In all other cohorts, no statistically significant difference was found between the procedures.

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