Gender differences in short-term cardiovascular outcomes after percutaneous coronary interventions.
Recent studies have been inconsistent in demonstrating a decrease in the gender gap in short-term post-percutaneous coronary intervention (PCI) outcomes. We sought to determine gender differences in outcomes in younger and older patients who underwent PCI during the current stent era. We studied 4,768 elective PCI procedures performed at Emory University Hospital from 2001 to 2004. The baseline characteristics, periprocedural complications, angiographic success, procedural success, and major in-hospital complications (death, myocardial infarction, and emergency coronary artery bypass graft surgery) after PCI were compared between men and women. Women were more likely to be nonwhite and older, with a greater prevalence of hypertension and diabetes mellitus (all p <0.001) compared with men. After adjusting for baseline characteristics and coronary artery size, the incidence of coronary vascular injury complications was higher in women than in men, particularly in patients <or=55 years (odds ratio [OR] 2.74, 95% confidence interval [CI] 1.49 to 5.04). The difference was less when comparing women and men >55 years (OR 1.32, 95% CI 0.87 to 1.99, p = 0.047 for gender-age interaction). The adjusted odds of bleeding complications were also higher in women than in men (<or=55 years OR 5.39, 95% CI 2.26 to 12.8, >55 years OR 2.55, 95% CI 1.68 to 3.87, p = 0.121 for gender-age interaction). No significant gender differences were present in a combined end point of death, myocardial infarction, and emergency coronary artery bypass graft surgery. In conclusion, among patients who have undergone PCI, women, particularly younger women, are more likely than men to experience coronary vascular injury and bleeding complications unaccounted for by coronary artery size and other patient characteristics. No differences were found in major in-hospital complications by gender.
Argulian
Edgar
E
Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia, USA.
Patel
Amar D
AD
Abramson
Jerome L
JL
Kulkarni
Aniket
A
Champney
Kimberly
K
Palmer
Spencer
S
Weintraub
William
W
Wenger
Nanette K
NK
Vaccarino
Viola
V
D000368:Aged; D015906:Angioplasty, Balloon, Coronary / Q000009:adverse effects / Q000706:statistics & numerical data; D003324:Coronary Artery Disease / Q000401:mortality / Q000628:therapy*; D005260:Female; D017052:Hospital Mortality; D006760:Hospitalization; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D012737:Sex Factors; D015996:Survival Rate; D016896:Treatment Outcome