Clinical and angiographic characteristics of chronic total occlusion in female patients

AIM:To analyze the characteristics of female patients with chronic total occlusion (CTO) lesions by comparing clinical and angiographic features of male and female CTO patients undergoing coronary angiography. METHODS: A total of 1 716 CTO patients confirmed by coronary angiography between June 1989 and December 2005 were divided into two groups according to gender and data were retrospectively analyzed. After admission, patients underwent routine laboratory tests, X-rays, ultrasound cardiography, and coronary and left ventricle angiography. Coronary stenosis >50% was taken as a positive result, and coronary stenosis 100% or close to 100% with TIMI blood flow 0-1 grade as CTO lesions. RESULTS: Of the 1 716 CTO patients confirmed by coronary angiography, 334 were female (19.5%) and 1 382 male (80.5%). The mean age in the group of females was higher than in the male group ［(64±8) years vs. (60±11) years, P<0.01］. The rates of hypertension (65.6% vs. 53.3%) in the female group was higher than in the group of males, but the body mass index ［(65±10) kg vs. (75±10) kg, P<0.01］, smoking rates (11.1% vs. 46.7%, P<0.01), alcohol consumption (2.4% vs. 26.6%, P<0.01) and old myocardial infarction (38.0% vs. 52.7%, P<0.01) in the female group were lower than those in the group of males. The mean levels of triglycerides (TG) ［(2.3±2.0) mmol/L vs. (2.0±1.5) mmol/L, P<0.01］, total cholesterol (TC) ［(5.4±1.3) mmol/L vs. (5.0±2.4) mmol/L, P<0.01］, high-density lipoprotein cholesterol (HDL-C) ［(1.4±0.5) mmol/L vs. (1.3±0.4) mmol/L, P<0.01］, fasting plasma glucose (FPG) ［(6.1±1.7) mmol/L vs. (5.9±1.7) mmol/L, P<0.05］, fibrinogen (Fib) ［(4.1±1.3) g/L vs. (3.9±1.4) g/L, P<0.05］ and ejection fraction (EF) value ［(0.64±0.10) vs. (0.63±0.11), P<0.05］ in the group of females were higher than in the group of males, but mean levels of BUN ［(5.6±2.4) mmol/L vs. (5.9±2.0) mmol/L, P<0.05］ and creatinine (Cr) ［(81±31) μmol/L vs. (95±33) μmol/L, P<0.01］ in the female group were lower than those in the male group. No significant differences were observed between groups in rates of type of coronary dominance, single-vessel disease, multivessel disease, CTO distribution (LM, LAD, LCX or RCA) and collateral circulation, and angiographic complications. CONCLUSION: The rate of hypertension and some metabolic indexes including TG, TC, FPG and Fib in female CTO patients are higher than those in CTO patients. CTO female patients are older in age but their CTO is not more complex than in male CTO patients.