Gender Related Outcomes in Saphenous Vein Graft Interventions

Background: Saphenous vein graft percutaneous coronary intervention (SVG-PCI) is a common procedure in patients after coronary artery bypass grafting (CABG). Although internal mammary artery is considered optimal, SVG is still used in the majority of patients. Aims: Investigating the potential role of gender differences in the incidence and outcomes of SVG-PCI. Methods: The study was based on a prospectively collected registry of 1,199 consecutive patients (169 female) who underwent SVG-PCI in a tertiary medical center between 2004-2023. Primary outcomes included MACE [death, myocardial infarction (MI), target vessel revascularization (TVR), stroke] and its components, at 1 and 3 years. Results: Female patients were older (73.6±9.1 years vs. 70.6±9.7 years, p<0.001), suffered from higher rates of diabetes, peripheral vascular disease, and congestive heart failure (78.1% vs. 61.3% p<0.001, 13.6% vs. 7% p<0.003, 66.3% vs.51.8% p<0.001 respectively). Additionally, female patients had lower trans-radial access use (11.9% vs. 19.3%, p<0.025), and underwent SVG-PCI earlier following their CABG procedure (11.3 ±6.2 years vs 12.9 ±6.1 years, p<0.003), as compared to male patients. There were no differences in MACE rates between the groups. Mortality was higher in the female group at 1-year (13.6% vs. 6.9%, P =0.003), but no significant differences were observed at 3-years (24.3% vs. 20.9%, p =0.320). Cox regression analysis identified age, renal function, ejection fraction, MI and trans-femoral as independent risk factors for mortality. Conclusion: Gender-specific monitoring and early intervention, especially for women, are required for better management of graft patency, potentially improving long-term outcomes.