title: Comparison of Outcomes of Women Versus Men With Non-ST-elevation Acute Coronary Syndromes Undergoing Percutaneous Coronary Intervention (from the Japanese Nationwide Registry).
abstract: Previous studies have reported that women have worse outcomes than men after percutaneous coronary intervention (PCI), especially in patients with ST-elevation myocardial infarction. However, gender-related differences in patients with non-ST-elevation acute coronary syndromes (NSTE-ACS) have not been thoroughly investigated. In the Japanese nationwide registry, a total of 43,239 patients with NSTE-ACS from 861 hospitals underwent PCI in 2014. Overall, 11,326 patients (26.2%) were women. The women were older (75.0 ± 10.3 vs 68.7 ± 11.4 years, p <0.001) and had a higher prevalence of hypertension (p <0.001), hyperlipidemia (p = 0.003), and heart failure (p <0.001) compared with men. For inpatient outcomes, women had a higher rate of overall complications (3.3% vs 2.4%, p <0.001) and bleeding complications that required blood transfusion (0.6% vs 0.2%, p <0.001). On multivariate analysis, female gender was an independent predictor of overall (odds ratio [OR] 1.20, 95% CI 1.04 to 1.38; p = 0.011) and bleeding complications (OR 1.94, 95% CI 1.35 to 2.79; p <0.001) after adjustment but was not associated with in-hospital mortality (OR 1.05, 95% CI 0.79 to 1.40; p = 0.747). In conclusion, in patients with NSTE-ACS who underwent PCI, women were at greater risk than men for in-hospital complications, especially in bleeding complications.
authors.affiliation: Department of Cardiology, Japanese Red Cross Ashikaga Hospital, Ashikaga, Japan. Electronic address: numasawa@cpnet.med.keio.ac.jp.
authors.forename: Yohei
authors.initials: Y
authors.lastname: Numasawa
authors.affiliation: Department of Cardiology, Keio University School of Medicine, Tokyo, Japan.
authors.forename: Taku
authors.initials: T
authors.lastname: Inohara
authors.affiliation: Department of Cardiology, Nagoya University Graduate School of Medicine, Nagoya, Japan.
authors.forename: Hideki
authors.initials: H
authors.lastname: Ishii
authors.affiliation: Department of Cardiology, Japanese Red Cross Ashikaga Hospital, Ashikaga, Japan.
authors.forename: Toshiki
authors.initials: T
authors.lastname: Kuno
authors.affiliation: Department of Cardiology, Japanese Red Cross Ashikaga Hospital, Ashikaga, Japan.
authors.forename: Masaki
authors.initials: M
authors.lastname: Kodaira
authors.affiliation: Department of Cardiology, Keio University School of Medicine, Tokyo, Japan.
authors.forename: Shun
authors.initials: S
authors.lastname: Kohsaka
authors.affiliation: Division of Cardiology, Sakurabashi Watanabe Hospital, Osaka, Japan.
authors.forename: Kenshi
authors.initials: K
authors.lastname: Fujii
authors.affiliation: Department of Cardiology, Kawasaki Medical School, Kurashiki, Japan.
authors.forename: Shiro
authors.initials: S
authors.lastname: Uemura
authors.affiliation: Department of Cardiology, Aichi Medical University, Nagakute, Japan.
authors.forename: Tetsuya
authors.initials: T
authors.lastname: Amano
authors.affiliation: Department of Cardiology, Kurashiki Central Hospital, Kurashiki, Japan.
authors.forename: Kazushige
authors.initials: K
authors.lastname: Kadota
authors.affiliation: Division of Cardiovascular Medicine, Toho University Ohashi Medical Center, Tokyo, Japan.
authors.forename: Masato
authors.initials: M
authors.lastname: Nakamura
mesh_terms: D054058:Acute Coronary Syndrome / Q000401:mortality / Q000628:therapy*; D000368:Aged; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D007564:Japan / Q000453:epidemiology; D008297:Male; D062645:Percutaneous Coronary Intervention; D011446:Prospective Studies; D012042:Registries; D012737:Sex Factors; D016896:Treatment Outcome