title: Gender difference in long-term clinical outcomes following percutaneous coronary intervention during 1984-2008.
abstract: OBJECTIVE
  Female has been demonstrated to be at higher risk following percutaneous coronary intervention (PCI) compared with male in unadjusted analyses. However, conflicting results were observed after adjustment of confounding factors. Particularly, more recent studies reported that gender differences have diminished possibly by evolution of PCI-related devices and evidence-based medical therapy. We aimed to examine gender differences in long-term clinical outcomes following PCI during time period of 25 years.
  
  
  METHODS
  This was a single center retrospective study in which consecutive patients who received the first PCI in our institution between January 1984 and December 2008 were analyzed. A composite of all-cause death and acute coronary syndrome (ACS) at 5-year after the index PCI was compared between genders. The endpoint was also examined in plain-old balloon angioplasty (POBA)-, bare metal stent (BMS)- and drug-eluting stent (DES)-eras separately.
  
  
  RESULTS
  A total of 3531 patients (female; 605, male; 2926) were analyzed. The female patients had higher risk profiles than the male in terms of age, comorbid diseases, a prevalence of ACS, while male patients had a higher percentage of smoking, lower left ventricular ejection fraction (LVEF) and lower percentages of secondary prevention drugs. Gender difference was not observed in 5-year all-cause death and ACS in multivariable Cox regression analysis. After controlling variables, age, body mass index, hemoglobin value and LVEF were associated with the clinical outcomes in both genders.
  
  
  CONCLUSIONS
  Gender difference was not observed in the long-term all-cause death and ACS in patients following PCI.
authors.affiliation: Department of Cardiovascular Medicine, Juntendo University Graduate School of Medicine, Japan.
authors.forename: Ryo
authors.initials: R
authors.lastname: Naito
authors.affiliation: Department of Cardiovascular Medicine, Juntendo University Graduate School of Medicine, Japan. Electronic address: ktmmy@med.juntendo.ac.jp.
authors.forename: Katsumi
authors.initials: K
authors.lastname: Miyauchi
authors.affiliation: Department of Cardiovascular Medicine, Juntendo University Graduate School of Medicine, Japan.
authors.forename: Hirokazu
authors.initials: H
authors.lastname: Konishi
authors.affiliation: Department of Cardiovascular Medicine, Juntendo University Graduate School of Medicine, Japan.
authors.forename: Shuta
authors.initials: S
authors.lastname: Tsuboi
authors.affiliation: Department of Cardiovascular Medicine, Juntendo University Graduate School of Medicine, Japan.
authors.forename: Manabu
authors.initials: M
authors.lastname: Ogita
authors.affiliation: Department of Cardiovascular Medicine, Juntendo University Graduate School of Medicine, Japan.
authors.forename: Tomotaka
authors.initials: T
authors.lastname: Dohi
authors.affiliation: Department of Cardiovascular Medicine, Juntendo University Graduate School of Medicine, Japan.
authors.forename: Takatoshi
authors.initials: T
authors.lastname: Kasai
authors.affiliation: Department of Cardiovascular Medicine, Juntendo University Graduate School of Medicine, Japan.
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Tamura
authors.affiliation: Department of Cardiovascular Medicine, Juntendo University Graduate School of Medicine, Japan.
authors.forename: Shinya
authors.initials: S
authors.lastname: Okazaki
authors.affiliation: Department of Cardiovascular Medicine, Juntendo University Graduate School of Medicine, Japan.
authors.forename: Kikuo
authors.initials: K
authors.lastname: Isoda
authors.affiliation: Department of Cardiovascular Medicine, Juntendo University Graduate School of Medicine, Japan.
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Daida
mesh_terms: D054058:Acute Coronary Syndrome / Q000000981:diagnostic imaging / Q000401:mortality / Q000503:physiopathology / Q000628:therapy*; D000367:Age Factors; D000368:Aged; D015906:Angioplasty, Balloon, Coronary / Q000009:adverse effects / Q000295:instrumentation / Q000401:mortality; D015415:Biomarkers / Q000097:blood; D015992:Body Mass Index; D016009:Chi-Square Distribution; D015897:Comorbidity; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging / Q000401:mortality / Q000503:physiopathology / Q000628:therapy*; D018572:Disease-Free Survival; D054855:Drug-Eluting Stents; D005260:Female; D054624:Health Status Disparities; D006454:Hemoglobins / Q000378:metabolism; D006801:Humans; D007564:Japan; D053208:Kaplan-Meier Estimate; D008297:Male; D008670:Metals; D008875:Middle Aged; D015999:Multivariate Analysis; D016016:Proportional Hazards Models; D011474:Prosthesis Design; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D012737:Sex Factors; D012907:Smoking / Q000009:adverse effects; D015607:Stents; D013318:Stroke Volume; D013997:Time Factors; D016896:Treatment Outcome; D016277:Ventricular Function, Left
chemical_list: D015415:Biomarkers; D006454:Hemoglobins; D008670:Metals
keywords: Coronary artery disease; Gender difference; Percutaneous coronary intervention