title: Sex differences in the treatment and outcome of patients with acute coronary syndrome after percutaneous coronary intervention: a population-based study.
abstract: BACKGROUND
  This study was performed to assess the influence of sex on drug therapy and long-term outcomes in acute coronary syndrome (ACS) patients who underwent percutaneous coronary intervention (PCI).
  
  
  METHODS
  This is a retrospective cohort study of ACS patients who underwent PCI [women (n=8,884) and men (n=23,937)] between January 1, 2006, and December 31, 2007, with at least a 1-year follow-up, based on the National Health Insurance Research Database in Taiwan. Propensity score was used to identify a 1:1 matched cohort (n=17,768) for multivariable adjustment. The influence of sex on drug therapy and outcomes was examined by multivariate logistic regression and multivariable Cox proportional hazards regression.
  
  
  RESULTS
  Female patients had an 18% and 12% lower likelihood of receiving aspirin (adjusted odds ratio [OR(adj)]=0.82, 95% confidence interval [CI]=0.77-0.88) and clopidogrel (OR(adj)=0.88, 95% CI=0.81-0.95), respectively, than male patients but had a 17% and 22% higher likelihood of receiving beta-blockers (OR(adj)=1.17, 95% CI=1.10-1.24) and statins (OR(adj)=1.22, 95% CI=1.14-1.29), respectively, than male patients in the matched cohort. The adjusted hazard ratio (HR(adj)) of rehospitalization for revascularization in women was 0.84 (95% CI=0.79-0.90) compared with men after at least a 1-year follow-up in the matched cohort.
  
  
  CONCLUSIONS
  Female patients with ACS who underwent PCI were less likely to receive aspirin and clopidogrel but were more likely to receive beta-blockers and statins than male patients. Male sex was associated with a higher risk of rehospitalization for revascularization than female sex.
authors.affiliation: 1 School of Pharmacy, College of Medicine, National Taiwan University , Taipei, Taiwan .
authors.forename: Chen-Fang
authors.initials: CF
authors.lastname: Lin
authors.forename: Li-Jiuan
authors.initials: LJ
authors.lastname: Shen
authors.forename: Fei-Yuan
authors.initials: FY
authors.lastname: Hsiao
authors.forename: Churn-Shiouh
authors.initials: CS
authors.lastname: Gau
authors.forename: Fe-Lin Lin
authors.initials: FL
authors.lastname: Wu
mesh_terms: D054058:Acute Coronary Syndrome / Q000188:drug therapy* / Q000601:surgery; D001241:Aspirin / Q000008:administration & dosage / Q000627:therapeutic use*; D000077144:Clopidogrel; D005260:Female; D006801:Humans; D007348:Insurance, Health / Q000706:statistics & numerical data; D008297:Male; D016017:Odds Ratio; D062645:Percutaneous Coronary Intervention; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use*; D011159:Population Surveillance; D057216:Propensity Score; D012044:Regression Analysis; D012189:Retrospective Studies; D012737:Sex Factors; D013624:Taiwan; D013988:Ticlopidine / Q000008:administration & dosage / Q000031:analogs & derivatives* / Q000627:therapeutic use; D016896:Treatment Outcome
chemical_list: D010975:Platelet Aggregation Inhibitors; D000077144:Clopidogrel; D013988:Ticlopidine; D001241:Aspirin