Vascular complications in women after catheterization and percutaneous coronary intervention 1998-2005.
BACKGROUND
Previous studies have indicated that women experience more vascular complications after cardiac catheterization (CATH) and percutaneous coronary intervention (PCI) than men. Whether awareness of this gender risk or implementation of strategies to reduce the overall incidence of vascular complications has had an effect on the incidence of vascular complications in women is unknown.


METHODS
A total of 31,035 consecutive diagnostic CATH (n = 18,467) and PCI procedures (n = 12,568) performed via femoral access at a single site (WFUBMC) between 1998 and 2005 were evaluated. The relative incidence of vascular complications was evaluated by logistic regression models adjusted for baseline covariates.


RESULTS
For the entire study period, the unadjusted incidence of any vascular complication was 2.0% for women and 1.0% for men; p < 0.05. The risk-adjusted odds ratio for any vascular complication comparing women to men for the entire study period was 1.75 (95% CI 1.37-2.23) for all procedures, 1.66 (1.17-2.36) for CATH, and 1.83 (1.32-2.54) for PCI. However, the incidence of vascular complications fell for women during the study period; p < 0.001 for trend. In 2005, the adjusted relative risk of any vascular complications in women was not significantly higher than for men OR 0.98 (0.33-2.87).


CONCLUSIONS
In this large, single-center, contemporary observational study, female gender was the strongest independent predictor of any vascular complication after CATH and PCI. However, the incidence of vascular complications in women decreased over the 8-year study period, and the increased risk of vascular complications in women compared to men was no longer present in 2005.
Applegate
Robert J
RJ
Wake Forest University School of Medicine, Section of Cardiology, Winston-Salem, NC 27157-1045, USA. bapplega@wfubmc.edu
Sacrinty
Matthew T
MT
Kutcher
Michael A
MA
Baki
Talal T
TT
Gandhi
Sanjay K
SK
Kahl
Frederic R
FR
Santos
Renato M
RM
Little
William C
WC
D000368:Aged; D015906:Angioplasty, Balloon, Coronary / Q000009:adverse effects* / Q000706:statistics & numerical data*; D006328:Cardiac Catheterization / Q000009:adverse effects* / Q000706:statistics & numerical data*; D003324:Coronary Artery Disease / Q000453:epidemiology* / Q000628:therapy*; D005260:Female; D006801:Humans; D015994:Incidence; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011237:Predictive Value of Tests; D012307:Risk Factors; D017678:Sex Distribution; D017211:Treatment Failure