***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: BACKGROUND Numerous studies have shown that women undergoing coronary revascularization procedures  do so at a higher risk for an adverse outcome compared with men . However , the impact of advances in technology and improvements in techniques on in-hospital and long-term outcome after revascularization in women is unclear . METHODS AND RESULTS We evaluated 1829 patients with symptomatic multivessel coronary disease r and omized to CABG or PTCA in the Bypass Angioplasty Revascularization Investigation ( BARI ) , of whom 27 % were women . As expected , women were older ( 64.0 versus 60.5 years ) , with more congestive heart failure ( 14 % versus 7 % ) , hypertension ( 68 % versus 42 % ) , treated diabetes mellitus ( 31 % versus 15 % ) , and unstable angina ( 67 % versus 61 % ) than men but had similar preservation of left ventricular function and extent of multivessel disease . Women assigned to surgery received the same number of  total grafts  but fewer  internal mammary artery grafts  ( 72 % versus 85 % , P<0 . 01 ) , and those assigned to angioplasty had more intended lesions ( 76 % versus 71 % , P<0.01 ) successfully dilated than men . At an average of 5.4 years ' follow-up , crude mortality rates were similar in women ( 12.8 % ) and men ( 12.0 % ) . The Cox regression model adjusting for baseline differences revealed that women had a significantly lower risk of death ( relative risk , 0.60 ; 95 % CI , 0.43 to 0.84 ; P=0 . 003 ) but not a significantly lower risk of death plus myocardial infa rct ion ( relative risk , 0.84 ; 95 % CI , 0.66 to 1.07 ; P=0.16 ) than men . CONCLUSIONS Although the unadjusted mortality rate suggests that women and men undergoing CABG and PTCA have a similar 5-year mortality , women have higher risk profiles ; consequently , contrary to previous reports , female sex is an independent predictor of improved 5-year survival after we control for multiple risk factors BACKGROUND Blockade of the platelet glycoprotein IIb/IIIa receptor with abciximab ( a monoclonal-antibody Fab fragment directed against the receptor ) has been shown to diminish ischemic complications among patients undergoing high-risk coronary angioplasty or directional atherectomy but increases bleeding complications . The widespread applicability of this treatment is unknown , particularly in view of the observed risk of hemorrhage . METHODS In a prospect i ve , double-blind trial , we r and omly assigned patients undergoing urgent or elective percutaneous coronary revascularization at 69 centers to receive abciximab with st and ard-dose , weight-adjusted heparin ( initial bolus of 100 U per kilogram of body weight ) ; abciximab with low-dose , weight-adjusted heparin ( initial bolus of 70 U per kilogram ) ; or placebo with st and ard-dose , weight-adjusted heparin . The primary efficacy end point was death from any cause , myocardial infa rct ion , or urgent revascularization within 30 days of r and omization . RESULTS The trial was terminated at the first interim analysis , with 2792 of the planned 4800 patients enrolled . At 30 days , the composite event rate was 11.7 percent in the group assigned to placebo with st and ard-dose heparin ; 5.2 percent in the group assigned to abciximab with low-dose heparin ( hazard ratio , 0.43 ; 95 percent confidence interval , 0.30 to 0.60 ; P<0.001 ) ; and 5.4 percent in the group assigned to abciximab with st and ard-dose heparin ( hazard ratio , 0.45 ; 95 percent confidence interval , 0.32 to 0.63 ; P<0.001 ) . There were no significant differences among the groups in the risk of major bleeding , although minor bleeding was more frequent among patients receiving abciximab with st and ard-dose heparin . CONCLUSIONS Inhibition of the platelet glycoprotein IIb/IIIa receptor with abciximab , together with low-dose , weight-adjusted heparin , markedly reduces the risk of acute ischemic complications in patients undergoing percutaneous coronary revascularization , without increasing the risk of hemorrhage OBJECTIVE The quality of target vessels may affect gender differences in outcome after  coronary artery bypass grafting .  This prospect i ve study compares preoperative angiographic assessment of vessel quality with intraoperative visual assessment of size and presence or absence of diffuse disease . The effect of vessel quality on operative mortality and late survival is examined . METHODS Data were prospect ively collected on 1939 consecutive patients undergoing isolated coronary artery bypass grafting by a single surgeon . Quality of target vessels was assessed preoperatively ( angiogram ) and intraoperatively by inspection and probe calibration . RESULTS Vessels were poorly visualized in 29 % of female patients and 37 % of male patients ( P = .004 ) , although all but 1.6 % of target vessels were grafted . Women were no more likely than men to have small vessels ( < 1.5 mm ) ( 57 % vs 59 % , P = .449 ) and were less likely to have distal disease ( 45 % vs 53 % , P = .005 ) . Operative mortality was low , not statistically different in women versus men ( 1.3 % vs 0.7 % , P = .237 ) , and increased in patients with distal disease ( 1.3 % vs.03 % , P = .021 ) . Late survival was decreased in patients with poor left ventricle function , congestive heart failure , and peripheral vascular disease . Late survival was decreased in men with increased age , class IV symptoms , small size , and no left internal thoracic artery graft , and in women with recent myocardial infa rct ion and preoperative cerebrovascular accident . CONCLUSION We conclude that in most patients with poorly visualized vessels in the preoperative angiogram , complete revascularization can be achieved if one is willing to graft small or diffusely diseased vessels . Women are no more likely than men to have vessels less than 1.5 mm in size and are less likely to have diffuse disease . Such an approach is associated with a low operative mortality and good long-term survival . Predictors of late survival were different for men and women . Neither small vessel size nor diffuse disease was an independent predictors of poor late outcome Background —Women with acute myocardial infa rct ion ( AMI ) undergoing primary angioplasty  have higher rates of morbidity and mortality than do men . Whether contemporary interventional treatment strategies have improved outcomes for women compared with men is unknown . Methods and Results —In the CADILLAC trial , 2082 patients ( 27 % women ) with AMI within 12 hours of symptom onset were r and omized to balloon angioplasty ( PTCA ;  n=518 ) , PTCA+abciximab ( n=528 ) , stenting ( n=512 ) , and stenting+abciximab ( n=524 ) . As compared with men , women had a lower body surface area ; had a greater prevalence of diabetes , hypertension , and hyperlipidemia ; experienced significant delays to treatment ; and had better baseline and final TIMI grade 3 flows . Unadjusted 1-year event rates were higher for women , including death ( 7.6 % versus 3.0 % , P<0.001 ) , ischemic target-vessel revascularization ( TVR ; 16.7 % versus 12.1 % , P=0.006 ) , and major adverse cardiac events ( MACE ; 23.9 % versus 15.3 % , P<0.001 ) . Female gender was an independent predictor of MACE and bleeding complications , although comorbid risk factors and body surface area but not gender predicted 1-year death . For women , primary stenting result ed in a reduction in 1-year MACE from 28.1 % to 19.1 % ( P=0.01 ) and in ischemic TVR from 20.4 % to 10.8 % ( P=0.002 ) compared with PTCA . The addition of abciximab to primary stenting significantly reduced the 30-day ischemic TVR without increasing bleeding or stroke rates . Conclusions —The higher mortality rate in women compared with men after interventional treatment for AMI may be explained by differences in body size and clinical risk factors , although female gender remains an important independent determinant of overall adverse outcomes . For women in the CADILLAC trial , the addition of abciximab reduced 30-day TVR without increasing bleeding risk , and primary stenting reduced 1-year TVR and MACE rates compared with PTCA Background —Although most r and omized clinical trials have suggested that long-term survival rates after percutaneous coronary intervention ( PCI ) or surgical multivessel coronary revascularization ( CABG ) are equivalent , some post hoc analyses in high-risk groups and adjustment for severity of coronary disease have suggested higher mortality after PCI . Methods and Results —We studied 6033 consecutive patients who underwent revascularization in the late 1990s . PCI was performed in 872 patients ; 5161 underwent CABG . Half the patients had significant left ventricular dysfunction or diabetes . Propensity analysis to predict the probability of undergoing PCI according to 22 variables and their interactions was used . The C-statistic for this model was 0.90 , indicating excellent discrimination between treatments . There were 931 deaths during 5 years of follow-up . The 1- and 5-year unadjusted mortality rates were 5 % and 16 % for PCI and 4 % and 14 % for CABG ( unadjusted hazard ratio , 1.13 ; 95 % CI , 1.0 to 1.4 ; P = 0.07 ) . PCI was associated with an increased risk of death ( propensity-adjusted hazard ratio , 2.3 ; 95 % CI , 1.9 to 2.9 ; P < 0.0001 ) . This difference was observed across all categories of propensity for PCI and in patients with diabetes or left ventricular dysfunction . Other independent predictors of mortality ( P ≤0.01 for all ) were renal dysfunction , age , diabetes mellitus , chronic lung disease , peripheral vascular disease , left main trunk stenosis , and extent of coronary disease ( Duke angiographic score ) . Conclusions —In patients with multivessel coronary artery disease and many high-risk characteristics , CABG was associated with better survival  than PCI after adjustment for risk profile Background —The effectiveness of sirolimus-eluting stents in unselected patients treated in the daily practice is currently unknown . Methods and Results —Sirolimus-eluting stent implantation has been used as the default strategy for all percutaneous procedures in our hospital as part of the R apamycin-E luting S tent E valuated A t R otterdam C ardiology H ospital ( RESEARCH ) registry . Consecutive patients with de novo lesions ( n=508 ) treated exclusively with sirolimus-eluting stents ( SES group ) were compared with 450 patients who received bare stents in the period just before ( pre-SES group )  . Patients in the SES group more frequently had multivessel disease , more type C lesions , received more stents , and had more bifurcation stenting . At 1 year , the cumulative rate of major adverse cardiac events ( death , myocardial infa rct ion , or target vessel revascularization ) was 9.7 % in the SES group and 14.8 % in the pre-SES group ( hazard ratio [ HR ] , 0.62 [ 95 % CI , 0.44 to 0.89 ] ; P = 0.008 ) . The 1-year risk of clinical ly driven target vessel revascularization in the SES group and in the pre-SES group was 3.7 % versus 10.9 % , respectively ( HR , 0.35 [ 95 % CI , 0.21 to 0.57 ] ; P < 0.001 ) . Conclusions —Unrestricted utilization of sirolimus-eluting stents in the “ real world ” is safe and effective in reducing both repeat revascularization and major adverse cardiac events at 1 year compared with bare stent implantation BACKGROUND Coronary artery diameter is known to be inversely associated with perioperative mortality related to coronary artery bypass grafting ( CABG ) . This association is believed to be responsible for increased risk among women and smaller people . However , the associations between sex , body size , and coronary size have not been carefully examined because direct information about coronary size is rarely available . Also , whether sex has an independent effect on vessel size is largely unknown . METHODS AND RESULTS Height , weight , sex , age , status at hospital discharge , and luminal diameter of the midleft anterior descending coronary artery ( mid-LAD ) were recorded prospect ively in 1325 patients undergoing CABG .  Small vessel size was associated with substantially increased risk of in-hospital mortality ( 15.8 % for 1.0-mm vessels , 4.6 % for 1.5- to 2.0-mm vessels , and 1.5 % for 2.5- to 
    Output:
    
The majority of studies noted greater in-hospital mortality in women than in men , with mortality differences resolving with longer follow-up .
Early mortality differences were reduced but not consistently eliminated after adjustment for comorbidities , procedural characteristics , and body habitus .
Gender was an independent risk factor for complications after both CABG and PCI .
Women experience greater complications and early mortality after revascularization .