title: Improved outcomes for women undergoing contemporary percutaneous coronary intervention: a report from the National Heart, Lung, and Blood Institute Dynamic registry.
abstract: OBJECTIVE
  The goal of this study was to determine whether women undergoing contemporary percutaneous coronary intervention (PCI) remain at increased risk in comparison with men and whether the outcomes in women have improved.
  
  
  BACKGROUND
  Previous studies have shown that women treated with coronary angioplasty have a higher incidence of procedural morbidity and mortality than men.
  
  
  METHODS
  Gender differences in wave 1 of the National Heart, Lung and Blood Institute (NHLBI) Dynamic registry were evaluated. Baseline characteristics and outcomes in women in the Dynamic registry were compared with those in women in the 1985-1986 and 1993-1994 NHLBI Percutaneous Transluminal Coronary Angioplasty (PTCA) registries.
  
  
  RESULTS
  Women were older with a higher prevalence of diabetes mellitus, hypertension, congestive heart failure, unstable angina and single vessel disease in comparison with men. Although procedural success and in-hospital death (2.2% vs. 1.3%), myocardial infarction (MI) (2.3% vs. 3.0%) and coronary artery bypass graft surgery (CABG) (1.3% vs. 1.4%) were similar in women and men, respectively, one-year mortality (6.5% vs. 4.3%, p = 0.02) and combined end point of death/MI/CABG (18.3% vs. 14.4%, p = 0.03) were higher in women than in men. After controlling for other factors, gender was not a significant predictor of death or death plus MI at one year. Despite a higher risk profile in women in the Dynamic registry in comparison with women in the 1985-1986 NHLBI PTCA registry, in-hospital death/MI/CABG was lower (6.0% vs. 11.6%, p < 0.001).
  
  
  CONCLUSIONS
  Despite persistent high-risk characteristics in women, gender differences in outcomes in patients undergoing contemporary PCI have decreased, and outcomes in women have improved.
authors.affiliation: Evans Memorial Department of Medicine, Boston University Medical Center, Boston, Massachusetts, USA. alice.jacobs@bmc.edu
authors.forename: Alice K
authors.initials: AK
authors.lastname: Jacobs
authors.forename: Janet M
authors.initials: JM
authors.lastname: Johnston
authors.forename: Amelia
authors.initials: A
authors.lastname: Haviland
authors.forename: Maria Mori
authors.initials: MM
authors.lastname: Brooks
authors.forename: Sheryl F
authors.initials: SF
authors.lastname: Kelsey
authors.forename: David R
authors.initials: DR
authors.lastname: Holmes
authors.forename: David P
authors.initials: DP
authors.lastname: Faxon
authors.forename: David O
authors.initials: DO
authors.lastname: Williams
authors.forename: Katherine M
authors.initials: KM
authors.lastname: Detre
mesh_terms: D000368:Aged; D015906:Angioplasty, Balloon, Coronary; D003327:Coronary Disease / Q000401:mortality / Q000628:therapy*; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D008297:Male; D008875:Middle Aged; D012042:Registries; D012307:Risk Factors; D012737:Sex Factors; D016019:Survival Analysis; D014481:United States