In the Journals

Women undergo peripheral endovascular intervention for PAD later in life than men

Endovascular intervention for peripheral artery disease is performed at an older age in women compared with men, according to data published in Circulation: Cardiovascular Interventions.

“Elderly patients constitute the fastest-growing segment of the U.S. population, and women outnumber men in this demographic group. As the population ages, the prevalence of PAD will create substantial financial and resource burdens on the health care system,” Niveditta Ramkumar, MPH, from the Dartmouth Institute for Health Policy and Clinical Practice in Lebanon, New Hampshire, and colleagues wrote. “Moreover, according to the 2010 United States Census, the prevalence of PAD is higher in women than men. Yet, PAD remains under-recognized and undertreated among women.”

To further explore sex-based differences in treatment of PAD, Ramkumar and colleagues used national registry data from the Vascular Quality Initiative between 2010 and 2013 to examine patient, limb and artery characteristics by sex via descriptive statistics.

The researchers analyzed 26,750 procedures performed in 23,820 patients to treat 30,545 limbs and 44,804 arteries.

Compared with men, women presented at an older age (69 vs. 67 years; P< .001) and were less likely to be current or former smokers (72% vs. 85%; P < .001).

TransAtlantic Inter-Society Consensus classification (TASC C or D: 37% in men and women; P = .81) and mean occlusion length (4.5 cm in men vs. 4.6 cm in women; P = .04) were similar among men and women, even after researchers accounted for lesion location.

According to Ramkumar and colleagues, women were more likely than men to undergo treatment for rest pain (16% vs. 11%; P < .001) vs. claudication (53% in women vs. 59% in men; P < .001) or tissue loss (27% in women vs. 28% in men; P = .75).

Treatment modality was similar in both sexes, but it was linked to disease severity (P for trend < .001) and lesion location (P for trend < .001).

“We identified that women clinically present at an older age with more advanced arterial disease but are less likely to have comorbid coronary artery disease or be actively smoking,” the researchers wrote. “These differences could be because of a varied disease pathophysiology or represent limitations to health care access, among others, for women compared with men and, thus, warrant further study.” – by Dave Quaile

Disclosure: The authors report no relevant financial disclosures.

Endovascular intervention for peripheral artery disease is performed at an older age in women compared with men, according to data published in Circulation: Cardiovascular Interventions.

“Elderly patients constitute the fastest-growing segment of the U.S. population, and women outnumber men in this demographic group. As the population ages, the prevalence of PAD will create substantial financial and resource burdens on the health care system,” Niveditta Ramkumar, MPH, from the Dartmouth Institute for Health Policy and Clinical Practice in Lebanon, New Hampshire, and colleagues wrote. “Moreover, according to the 2010 United States Census, the prevalence of PAD is higher in women than men. Yet, PAD remains under-recognized and undertreated among women.”

To further explore sex-based differences in treatment of PAD, Ramkumar and colleagues used national registry data from the Vascular Quality Initiative between 2010 and 2013 to examine patient, limb and artery characteristics by sex via descriptive statistics.

The researchers analyzed 26,750 procedures performed in 23,820 patients to treat 30,545 limbs and 44,804 arteries.

Compared with men, women presented at an older age (69 vs. 67 years; P< .001) and were less likely to be current or former smokers (72% vs. 85%; P < .001).

TransAtlantic Inter-Society Consensus classification (TASC C or D: 37% in men and women; P = .81) and mean occlusion length (4.5 cm in men vs. 4.6 cm in women; P = .04) were similar among men and women, even after researchers accounted for lesion location.

According to Ramkumar and colleagues, women were more likely than men to undergo treatment for rest pain (16% vs. 11%; P < .001) vs. claudication (53% in women vs. 59% in men; P < .001) or tissue loss (27% in women vs. 28% in men; P = .75).

Treatment modality was similar in both sexes, but it was linked to disease severity (P for trend < .001) and lesion location (P for trend < .001).

“We identified that women clinically present at an older age with more advanced arterial disease but are less likely to have comorbid coronary artery disease or be actively smoking,” the researchers wrote. “These differences could be because of a varied disease pathophysiology or represent limitations to health care access, among others, for women compared with men and, thus, warrant further study.” – by Dave Quaile

Disclosure: The authors report no relevant financial disclosures.

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