Sex difference in clinical outcomes after percutaneous coronary intervention in Korean population.
BACKGROUND
Conflicting data on sex-based differences in outcomes after percutaneous coronary intervention (PCI) among Western population exist. Little is known about the nature of sex-specific PCI outcomes in an Asian population.


METHODS
We performed a pooled analysis using 23,604 patients from 11 prospective PCI clinical studies performed in Korea. The primary outcome was a major cardiovascular event, defined as composite of cardiovascular death, myocardial infarction, stent thrombosis, or stroke. Secondary outcomes were all-cause mortality and target vessel revascularization.


RESULTS
Thirty-day and 2-year rates of major cardiovascular events were more frequent in women than in men, mainly because of a higher incidence of periprocedural myocardial infarction in women (30-day: 9.2% vs 7.1%; 2-year: 11.2% vs 8.9%). After multivariable adjustment, women had significantly higher risks of 30-day (hazard ratio [HR] 1.27, 95% CI 1.19-1.36) and 2-year major cardiovascular events (HR 1.21, 95% CI 1.13-1.30). Unadjusted 30-day and 2-year all-cause mortality was similar between women and men (30-day: 0.5% vs 0.4%; 2-year: 2.8% vs 2.8%). However, after multivariable adjustment, women had a lower adjusted risk of 2-year death (HR 0.82, 95% CI 0.77-0.87). No sex-based difference was observed for target vessel revascularization (HR 1.07, 95% CI 0.91-1.25). Overall, sex-specific findings for outcomes were consistent across multiple patient subgroups.


CONCLUSIONS
Among Korean population undergoing contemporary PCI, women have a significantly higher risk of short- and long-term major cardiovascular events than do men but have better long-term survival.
Department of Cardiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea.
Duk-Woo
DW
Park
Department of Cardiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea.
Young-Hak
YH
Kim
Division of Biostatistics of Center for Medical Research and Information, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea.
Sung-Cheol
SC
Yun
Department of Cardiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea.
Jung-Min
JM
Ahn
Department of Cardiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea.
Jong-Young
JY
Lee
Department of Cardiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea.
Soo-Jin
SJ
Kang
Department of Cardiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea.
Seung-Whan
SW
Lee
Department of Cardiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea.
Cheol Whan
CW
Lee
Department of Cardiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea.
Seong-Wook
SW
Park
Department of Cardiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea. Electronic address: sjpark@amc.seoul.kr.
Seung-Jung
SJ
Park
D000368:Aged; D002986:Clinical Trials as Topic; D003324:Coronary Artery Disease / Q000453:epidemiology / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D062645:Percutaneous Coronary Intervention; D056910:Republic of Korea / Q000453:epidemiology; D012307:Risk Factors; D017678:Sex Distribution; D012737:Sex Factors; D015996:Survival Rate / Q000639:trends; D013997:Time Factors; D016896:Treatment Outcome