Gender differences in percutaneous coronary intervention (PCI) in the drug eluting stent (DES) era: Melbourne Interventional Group (MIG) Registry

used in appropriate clinical situations, has a significant impact on day-to-day decision making in the cath lab. doi:10.1016/j.hlc.2009.05.526 481 GENDER DIFFERENCES IN PERCUTANEOUS CORONARY INTERVENTION (PCI) IN THE DRUG ELUTING STENT (DES) ERA: MELBOURNE INTERVENTIONAL GROUP (MIG) REGISTRY J. Sapontis, S.L. Ching, M.J. Moore, W. Childs, L. Roberts, A. Brennan, N. Adrianopoulos, C. Reid, A. Black, G. New, on behalf of the Melbourne Interventional Group Box Hill Hospital, Eastern Health, Melbourne, Australia Background: It is controversial whether there are gender differences in outcomes after PCI. The aim of this study was to evaluate; whether DES or BMS (bare metal stent) have better outcomes in women, and if so, does this bridge the gender gap between men and women undergoing PCI. Methods: We compared short- and long-term outcomes in women and men receiving DES or BMS in elective and ACS patients undergoing PCI. Results: There were 2630 men and 901 women who received a DES and 2711 men and 923 women received a BMS. There were expected differences in demographics and procedural characteristics between groups. In women, there was a significant 30-day mortality benefit of DES over BMS (1.8% vs. 3.4%, P < 0.05), despite the DES group having more diabetic and STEMI patients. There was no difference in mortality/MACE at 12 months. Compared to women, men had a lower 30-day mortality (1.8% vs. 3.4%, P < 0.05) and MACE (4.2% vs. 6.2%, P < 0.05) with BMS. With DES, men in comparison to women had lower 30-day mortality (1% vs. 1.8%, P < 0.05) and 30-day MACE (4.4% vs. 6.1%, P < 0.05). However, there was no difference in 12month mortality/MACE either between women and men or DES and BMS. Conclusion: In this large real-world registry, it appears females have worse short term outcomes in comparison to males, however, these differences were not apparent at 1-year follow-up. doi:10.1016/j.hlc.2009.05.527 482 HAEMORRHAGIC ACCESS SITE COMPLICATIONS IN TRANSRADIAL COMPARED TO TRANSFEMORAL PCI A. Nasis, Y. Malaiapan, B. Ko, J.D. Cameron, I.T. Meredith Monash Cardiovascular Research Centre, MonashHEART and Monash University Department of Medicine (MMC), Melbourne, Australia Background: Access site haemorrhagic complications post PCI are associated with increased mortality. Aim: To compare the rate of access site haemorrhagic complications in patients who underwent PCI at ele-

Abstracts

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vated bleeding risk (elderly patients, coronary bifurcation lesions and infarct angioplasty) using transradial (RPCI) compared to transfemoral (FPCI) access. Methods: Two-hundred patients (87% male, 64 ± 13 years) who underwent PCI between January 2005 and June 2008 were retrospectively analysed. One-hundred underwent RPCI (30 aged >70, 30 to a bifurcation lesion and 40 infarct angioplasty). These were compared to 100 age, gender and vessel matched controls undergoing FPCI. Data was prospectively collected for the RPCI cohort and retrospectively for the FPCI cohort. Results: Morphometric factors and cardiovascular risk profile were similar between the groups. One RPCI patient experienced a significant access site haemorrhagic complication (>5 cm haematoma) compared to five FPCI patients (P = 0.09), comprising four >5 cm haematomas and one pseudoaneurysm. There were 27 clinically insignificant <5 cm haematomas in the FPCI group (none in the RPCI group). No patients required blood transfusion. Six French sheaths were used in 99% of RPCI and 78% of FPCI cases (P < 0.001). Glycoprotein IIb/IIIa inhibitors were used in 41% of RPCI and 32% of FPCI cases (P = NS). Mean RPCI length of stay was 3.3 ± 0.2 days compared to 3.7 ± 0.4 for the FPCI cohort (P = NS). Conclusions: Transradial access for patients undergoing PCI at elevated bleeding risk appears to be associated with fewer haemorrhagic access site complications. This needs to be corroborated with prospectively collected and randomised data corrected for other bleeding risk factors. doi:10.1016/j.hlc.2009.05.528 483 HIGH RESOLUTION HISTOPATHOLOGICAL QUANTIFICATION AND ASSESSMENT OF EMBOLIC DEBRIS CAPTURED DURING SAPHENOUS VEIN GRAFT INTERVENTION G. Liew 1 , C. Hammett 1 , A. Thomas 2 , M. Worthley 1 , A. Zaman 3 , S. Worthley 1 1 Cardiovascular

Research Centre, Royal Adelaide Hospital & University of Adelaide, Adelaide, Australia 2 Department of Pathology, Flinders Medical Centre, Bedford Park, Australia 3 Department of Cardiology, Freeman Hospital, NewcastleUpon-Tyne, UK Background: The relationship between saphenous vein graft (SVG) plaque debris composition and embolic tendency during SVG intervention is unknown. We sought to quantify and investigate the individual histological components which make up embolic debris and their relationship to the amount of material captured by distal protection devices. Methods: Consecutive patients with clinical symptoms (n = 24, age 68 ± 9) undergoing SVG intervention were enrolled. In all patients a distal protection device, FilterWire EZ (Boston Scientific, Natick, MA) were used. Embolic debris captured by the FilterWire were weighed then fixed and stained for histopathological assessment by

ABSTRACTS

Heart, Lung and Circulation 2009;18S:S1–S286