title: Bleeding after percutaneous coronary intervention in women and men matched for age, body mass index, and type of antithrombotic therapy.
abstract: BACKGROUND
  Factors underlying the increased risk of bleeding after percutaneous coronary intervention (PCI) in women compared with men remain incompletely understood.
  
  
  METHODS
  The study included 3,351 women and 3,351 men matched for age, body mass index, and type of antithrombotic therapy. Bleeding within the 30 days after PCI was defined using the Bleeding Academic Research Consortium criteria. The main outcome was 1-year mortality.
  
  
  RESULTS
  Bleeding occurred in 518 women and 354 men (15.5% vs 10.6%, odds ratio [OR] 1.55, 95% CI 1.34-1.79, P < .001). Severe (Bleeding Academic Research Consortium class ≥2) bleeds (9.4% vs 6.5%, P < .001) and access site bleeds (10.1% vs 5.4%, P < .001) were more common in women. After adjustment, female sex remained an independent correlate of any bleeding (adjusted OR 1.61 [1.35-1.92], P < .001) and access site (adjusted OR 2.00 [1.59-2.50], P < .001) but not of nonaccess site (adjusted OR 1.18 [0.91-1.54], P = .205) bleeding. There were 248 deaths: 32 deaths among men with bleeding versus 107 deaths among men with no bleeding (9.1% vs 3.6%, OR 2.68 [1.78-4.05], P < .001) and 40 deaths among women with bleeding vs 69 deaths among women with no bleeding (7.8% vs 2.5%, OR 3.35 [2.24-5.01], P < .001). No difference in mortality was observed among women and men who bled (P = .487). Bleeding was independently associated 1-year mortality (adjusted hazard ratio 2.18 [1.68-2.84], P < .001) with no bleeding-by-sex interaction (P = .439).
  
  
  CONCLUSIONS
  Despite matching for age, body mass index, and type of antithrombotic therapy, bleeding risk after PCI remained significantly higher in women than in men. Bleeding was associated with increased risk of 1-year mortality with no bleeding-by-sex interaction.
authors.affiliation: Deutsches Herzzentrum München, Munich, Germany. Electronic address: ndrepepa@dhm.mhn.de.
authors.forename: Gjin
authors.initials: G
authors.lastname: Ndrepepa
authors.forename: Stefanie
authors.initials: S
authors.lastname: Schulz
authors.forename: Franz-Josef
authors.initials: FJ
authors.lastname: Neumann
authors.forename: Robert A
authors.initials: RA
authors.lastname: Byrne
authors.forename: Petra
authors.initials: P
authors.lastname: Hoppmann
authors.forename: Salvatore
authors.initials: S
authors.lastname: Cassese
authors.forename: Ilka
authors.initials: I
authors.lastname: Ott
authors.forename: Massimiliano
authors.initials: M
authors.lastname: Fusaro
authors.forename: Tareq
authors.initials: T
authors.lastname: Ibrahim
authors.forename: Tomohisa
authors.initials: T
authors.lastname: Tada
authors.forename: Gert
authors.initials: G
authors.lastname: Richardt
authors.forename: Karl-Ludwig
authors.initials: KL
authors.lastname: Laugwitz
authors.forename: Heribert
authors.initials: H
authors.lastname: Schunkert
authors.forename: Adnan
authors.initials: A
authors.lastname: Kastrati
mesh_terms: D000368:Aged; D015992:Body Mass Index; D005260:Female; D005343:Fibrinolytic Agents / Q000009:adverse effects / Q000627:therapeutic use*; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D062645:Percutaneous Coronary Intervention / Q000009:adverse effects* / Q000401:mortality; D019106:Postoperative Hemorrhage / Q000453:epidemiology* / Q000209:etiology / Q000401:mortality; D018570:Risk Assessment; D012307:Risk Factors; D012737:Sex Factors; D016019:Survival Analysis; D016896:Treatment Outcome
chemical_list: D005343:Fibrinolytic Agents