1.Gender differences in patients undergoing coronary stenting in current stent era.
Max WOO ; Chang-qing FAN ; Yung-Lung CHEN ; Hesham HUSEIN ; Hsiu-Yu FANG ; Cheng-Jui LIN ; Chiung-Jen WU
Chinese Medical Journal 2011;124(6):862-866
BACKGROUNDPrior studies have demonstrated worse results of women in both hospital and short-term outcomes post-percutaneous coronary intervention. However, with advanced devices like drug-eluting stents (DESs) available, there are no consistent data revealing gender impact in outcome. This study examined whether gender affected hospital outcome and showed one-year single-center patient results of coronary stenting.
METHODSThe study group included 969 consecutive patients (250 women and 719 men) undergoing coronary stenting for stable or unstable angina. Clinical events were assessed for at least 1 year post-procedure.
RESULTSCompared to men, women were older, presented more often with diabetes, hypertension, dyslipidemia, and lower creatinine clearance rate (Ccr); they had less percutaneous transluminal coronary angioplasty (PTCA) history, smaller vessel size, and shorter lesions. The hospital major adverse cardiovascular event (MACE) rate was 2.8% of women and 0.97% of men (P = 0.037). The one-year MACE rate was 10.0% of women and 10.4% of men (P = 0.874). After adjusting other covariates, women still had significantly higher hospital MACE rates (P = 0.034) and odds ratios (0.18; 95% confidence interval: 0.036-0.874). In women (n = 250), there was no statistically significant difference in hospital or one-year MACE between bare metal stent (BMS) and DES groups. Meanwhile, in men (n = 719), DES had a significant one-year improvement of MACE compared to BMS (P = 0.004). The female hospital MACE rate was five times greater than male results. However, there were similar one-year outcomes between women and men. DES currently have an advantage in long-term outcome.
CONCLUSIONSCurrently, with the use of BMS and DES, adverse hospital post-procedure cardiovascular event rate has occurred more often in women than in men. However, the MACE rate differences between women and men resolved with one year follow-up.
Aged ; Angina Pectoris ; therapy ; Angina, Unstable ; therapy ; Angioplasty, Balloon, Coronary ; adverse effects ; Female ; Humans ; Male ; Middle Aged ; Sex Factors ; Treatment Outcome
2.Clinical Features and Computed Tomography Characteristics of Non-Klebsiella pneumoniae Liver Abscesses in Elderly (>65 Years) and Nonelderly Patients.
Chih Weim HSIANG ; Chang Hsien LIU ; Hsiu Lung FAN ; Kai Hsiung KO ; Chih Yung YU ; Hong Hau WANG ; Wen I LIAO ; Hsian He HSU ; Wei Chou CHANG
Yonsei Medical Journal 2015;56(2):519-528
PURPOSE: To compare the clinical and computed tomography (CT) appearances of liver abscesses caused by non-Klebsiella pneumoniae bacterial pathogens in elderly and nonelderly patients. MATERIALS AND METHODS: Eighty patients with confirmed non-Klebsiella pneumoniae liver abscesses (non-KPLAs) were enrolled and divided into two age groups: elderly (age > or =65 years, n=42) and nonelderly (age <65 years, n=38). Diagnosis of non-KPLA was established by pus and/or blood culture. We compared clinical presentations, outcomes, and CT characteristics of the two groups, and performed multivariate analysis for significant variables and receiver-operating-characteristic analysis to determine the cutoff value of abscess diameter for predicting non-KPLA. RESULTS: Elderly patients with non-KPLA were associated with a longer hospital stay (p<0.01). Regarding etiology, biliary sources had a strong association in the elderly group (p<0.01), and chronic liver diseases were related to the nonelderly group (p<0.01). Non-KPLAs (52.5%) tended to show a large, multiloculated appearance in the elderly group and were associated with bile duct dilatation (p<0.01), compared with the nonelderly group. The abscess diameter (cutoff value, 5.2 cm; area under the curve, 0.78) between the two groups was predicted. In multivariate analysis, underlying biliary tract disease [odds ratio (OR), 3.58, p<0.05], abscess diameter (OR, 2.40, p<0.05), and multiloculated abscess (OR, 1.19, p<0.01) independently predicted elderly patients with non-KPLA. CONCLUSION: In the elderly patients with non-KPLA, a large, multiloculated abscess with a diameter greater than 5.2 cm was the predominant imaging feature.
Adult
;
Aged
;
Aged, 80 and over
;
Bacterial Infections/*complications/*radiography
;
Female
;
Humans
;
Klebsiella Infections/microbiology
;
Klebsiella pneumoniae
;
Length of Stay
;
Liver Abscess/complications/microbiology/*radiography
;
Logistic Models
;
Male
;
Microscopy
;
Middle Aged
;
Multivariate Analysis
;
ROC Curve
;
Retrospective Studies
;
Tomography, X-Ray Computed/*methods
3.Clinical Features and Computed Tomography Characteristics of Non-Klebsiella pneumoniae Liver Abscesses in Elderly (>65 Years) and Nonelderly Patients.
Chih Weim HSIANG ; Chang Hsien LIU ; Hsiu Lung FAN ; Kai Hsiung KO ; Chih Yung YU ; Hong Hau WANG ; Wen I LIAO ; Hsian He HSU ; Wei Chou CHANG
Yonsei Medical Journal 2015;56(2):519-528
PURPOSE: To compare the clinical and computed tomography (CT) appearances of liver abscesses caused by non-Klebsiella pneumoniae bacterial pathogens in elderly and nonelderly patients. MATERIALS AND METHODS: Eighty patients with confirmed non-Klebsiella pneumoniae liver abscesses (non-KPLAs) were enrolled and divided into two age groups: elderly (age > or =65 years, n=42) and nonelderly (age <65 years, n=38). Diagnosis of non-KPLA was established by pus and/or blood culture. We compared clinical presentations, outcomes, and CT characteristics of the two groups, and performed multivariate analysis for significant variables and receiver-operating-characteristic analysis to determine the cutoff value of abscess diameter for predicting non-KPLA. RESULTS: Elderly patients with non-KPLA were associated with a longer hospital stay (p<0.01). Regarding etiology, biliary sources had a strong association in the elderly group (p<0.01), and chronic liver diseases were related to the nonelderly group (p<0.01). Non-KPLAs (52.5%) tended to show a large, multiloculated appearance in the elderly group and were associated with bile duct dilatation (p<0.01), compared with the nonelderly group. The abscess diameter (cutoff value, 5.2 cm; area under the curve, 0.78) between the two groups was predicted. In multivariate analysis, underlying biliary tract disease [odds ratio (OR), 3.58, p<0.05], abscess diameter (OR, 2.40, p<0.05), and multiloculated abscess (OR, 1.19, p<0.01) independently predicted elderly patients with non-KPLA. CONCLUSION: In the elderly patients with non-KPLA, a large, multiloculated abscess with a diameter greater than 5.2 cm was the predominant imaging feature.
Adult
;
Aged
;
Aged, 80 and over
;
Bacterial Infections/*complications/*radiography
;
Female
;
Humans
;
Klebsiella Infections/microbiology
;
Klebsiella pneumoniae
;
Length of Stay
;
Liver Abscess/complications/microbiology/*radiography
;
Logistic Models
;
Male
;
Microscopy
;
Middle Aged
;
Multivariate Analysis
;
ROC Curve
;
Retrospective Studies
;
Tomography, X-Ray Computed/*methods