Comparison of differences in outcome after percutaneous coronary intervention in men versus women <40 years of age.
We evaluated the outcomes of 177 consecutive patients (43 women, 134 men) <40 years of age with premature atherosclerosis who underwent percutaneous coronary intervention. Women were younger, had more diabetes mellitus (37% vs 10%; p <0.001), but less hyperlipidemia (58% vs 75%; p <0.001) compared with men. In-hospital vascular complications and 1-year mortality rate or Q-wave myocardial infarction (7.9% vs 0.08%, p <0.01) were higher in women. By multivariable regression analysis, female gender was the only independent predictor of vascular complications (odds ratio, 14.1; 95% confidence intervals, 1.59 to 125, p = 0.01) and of 1-year mortality rate or nonfatal myocardial infarction (odds ratio, 12.5; 95% confidence interval, 1.14 to 111, p = 0.03). Women with premature coronary disease had a distinctive risk factor profile relative to men, with a predominance of diabetes and hypercholesterolemia, and were at higher risk of developing vascular and ischemic complications after percutaneous coronary intervention, warranting aggressive risk factor modification and vigilance in this population.
Lansky
Alexandra J
AJ
Cardiovascular Research Foundation, Lenox Hill Heart and Vascular Institute, New York, New York 10022, USA. alansky@crf.org
Mehran
Roxana
R
Dangas
George
G
Cristea
Ecaterina
E
Shirai
Kazuyuki
K
Costa
Ricardo
R
Costantini
Costantino
C
Tsuchiya
Yoshihiro
Y
Carlier
Stephane
S
Mintz
Gary
G
Cottin
Yves
Y
Stone
Gregg
G
Moses
Jeffrey
J
Leon
Martin B
MB
D000328:Adult; D015906:Angioplasty, Balloon, Coronary / Q000009:adverse effects*; D003324:Coronary Artery Disease / Q000209:etiology* / Q000401:mortality / Q000628:therapy*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D011183:Postoperative Complications; D012307:Risk Factors; D012737:Sex Factors; D016896:Treatment Outcome