Sex Differences in Clinical Features and Outcomes in Patients with Acute Coronary Syndrome Treated with Bifurcation Stenting Using the Double‐Kissing Culotte and Culotte Technique – 1-year Follow-up

Piotr Włodarczak,1 Mateusz Barycki,2 Szymon Włodarczak,1 Łukasz Furtan,2 Andrzej Giniewicz,3 Anita Chudaś,1 Waldemar Banasiak,4,5 Adrian Doroszko,4,5 Maciej Lesiak,6 Adrian Włodarczak,1,4 Piotr Rola2,4 1Department of Cardiology, The Copper Health Centre (MCZ), Lubin, 59-301, Poland; 2Department of Cardiology, Provincial Specialized Hospital, Legnica, 59-220, Poland; 3Faculty of Pure and Applied Mathematics, Wroclaw University of Science and Technology, Wroclaw, 50-981, Poland; 4Faculty of Medicine, Wroclaw University of Science and Technology, Wroclaw, 50-981, Poland; 5Department of Cardiology, Center for Heart Diseases, 4th Military Hospital, Wroclaw, 50-981, Poland; 6 1st Department of Cardiology, University of Medical Sciences, Poznan, 61-848, PolandCorrespondence: Piotr Rola, Faculty of Medicine, Wroclaw University of Science and Technology, Wroclaw, 50-981, Poland, Tel +0048767211442, Email [email protected]: Sex differences in the clinical course of coronary artery disease (CAD) particularly in Acute Coronary Syndrome (ACS), have been extensively hypothesized. Although coronary bifurcations account for approximately 20% of ACS cases, data concerning potential sex disparities in the outcomes of percutaneous interventions (PCI) remain scarce. Several data suggest the double kiss (DK) Culotte may provide advantages in bifurcation PCI. Therefore, we evaluate potential sex differences in relation to the Culotte technique.Patients and Methods: This study retrospectively analyzes sex disparities following PCI interventions in ACS patients using the DK-Culotte or Culotte technique for bifurcation lesions. The primary endpoint was Target Lesion Failure (TLF), a composite of cardiovascular death, target vessel myocardial infarction, or clinically driven target lesion revascularization (TLR). The secondary endpoint included major adverse cardiac events MACE (myocardial infarction, cardiac death, and target lesion revascularization).Results: There were no significant differences between sexes regarding TLF (DK-Culotte: Females 10.3% vs Males 5.7%; p=0.401; Culotte: Females 16.2% vs Males 11.8%; p=0.481) or MACE (DK-Culotte: Females 13.8% vs Males 12.5%; p=0.771; Culotte: Females 24.3% vs Males 17.6%; p=0.370) after a 1-year follow-up for both bifurcation techniques.Conclusion: The study found no significant differences in clinical outcomes between sexes following PCI for bifurcation lesions in the ACS cohort, regardless of whether the two-stent techniques (DK- Culotte or Culotte) were used.Keywords: sex differences, gender differences, acute coronary syndrome, coronary bifurcation, double-kiss culotte, culotte technique, percutaneous coronary intervention