title: Impact of Diabetes Mellitus on Ischemic Events in Men and Women After Percutaneous Coronary Intervention.
abstract: Studies have shown worse outcome for women compared with men after percutaneous coronary intervention (PCI), especially in the presence of diabetes mellitus (DM). We aimed to investigate the risk of ischemic events after PCI in women versus men stratified by the presence or absence of DM. A total of 17,154 consecutive patients from a single-center PCI registry enrolled from January 2009 to December 2014 were categorized accordingly: female/non-DM, female/DM, male/non-DM, and male/DM. End points included death and myocardial infarction (MI) at 1 year. Of the overall population, 15% (n = 2,631) were female/non-DM, 17% (n = 2,891) were female/DM, 38% (n = 6,483) were male/non-DM, and 30% (n = 5,149) were male/DM. Within the 4 study groups, female/DM had the highest risk, whereas female/non-DM and male/DM showed similar risks and male/non-DM showed lowest risk for death (4.64% vs 3.08% vs 2.93% vs 2.31%; p-trend <0.0001 over all groups and p = 0.69 between female/non-DM and male/DM, respectively) and MI (4.15% vs 3.99% vs 3.71% vs 2.55%; p trend <0.0001 over all groups and p = 0.97 between female/non-DM and male/DM, respectively). After multivariate adjustment findings were largely unchanged suggesting highest risk for adverse events in diabetic women compared with other groups and comparable risks for death and MI in nondiabetic women compared with diabetic men. In conclusion, these findings highlight the combined influence of DM and female gender as strong determinants of post-PCI risk while also illustrating "risk equivalence" between nondiabetic women versus diabetic men.
authors.affiliation: The Zena and Michael A. Wiener Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York, New York.
authors.forename: Serdar
authors.initials: S
authors.lastname: Farhan
authors.affiliation: The Zena and Michael A. Wiener Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York, New York.
authors.forename: Usman
authors.initials: U
authors.lastname: Baber
authors.affiliation: The Zena and Michael A. Wiener Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York, New York.
authors.forename: Birgit
authors.initials: B
authors.lastname: Vogel
authors.affiliation: The Zena and Michael A. Wiener Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York, New York.
authors.forename: Melissa
authors.initials: M
authors.lastname: Aquino
authors.affiliation: The Zena and Michael A. Wiener Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York, New York.
authors.forename: Jaya
authors.initials: J
authors.lastname: Chandrasekhar
authors.affiliation: The Zena and Michael A. Wiener Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York, New York.
authors.forename: Michela
authors.initials: M
authors.lastname: Faggioni
authors.affiliation: The Zena and Michael A. Wiener Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York, New York.
authors.forename: Gennaro
authors.initials: G
authors.lastname: Giustino
authors.affiliation: Third Department of Medicine, Division of Endocrinology and Metabolism, Medical University of Vienna, Vienna, Austria; Gender Medicine Unit, Medical University of Vienna, Vienna, Austria.
authors.forename: Alexandra
authors.initials: A
authors.lastname: Kautzky-Willer
authors.affiliation: Mount Sinai Medical Center, New York, New York.
authors.forename: Joesph
authors.initials: J
authors.lastname: Sweeny
authors.affiliation: Mount Sinai Medical Center, New York, New York.
authors.forename: Srushti
authors.initials: S
authors.lastname: Shah
authors.affiliation: Mount Sinai Medical Center, New York, New York.
authors.forename: Pooja
authors.initials: P
authors.lastname: Vijay
authors.affiliation: Mount Sinai Medical Center, New York, New York.
authors.forename: Nitin
authors.initials: N
authors.lastname: Barman
authors.affiliation: Mount Sinai Medical Center, New York, New York.
authors.forename: Pedro
authors.initials: P
authors.lastname: Moreno
authors.affiliation: Mount Sinai Medical Center, New York, New York.
authors.forename: Jason
authors.initials: J
authors.lastname: Kovacic
authors.affiliation: The Zena and Michael A. Wiener Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York, New York; Mount Sinai Medical Center, New York, New York.
authors.forename: George
authors.initials: G
authors.lastname: Dangas
authors.affiliation: The Zena and Michael A. Wiener Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York, New York; Mount Sinai Medical Center, New York, New York.
authors.forename: Annapoorna
authors.initials: A
authors.lastname: Kini
authors.affiliation: The Zena and Michael A. Wiener Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York, New York.
authors.forename: Roxana
authors.initials: R
authors.lastname: Mehran
authors.affiliation: The Zena and Michael A. Wiener Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York, New York; Mount Sinai Medical Center, New York, New York. Electronic address: samin.sharma@mountsinai.org.
authors.forename: Samin
authors.initials: S
authors.lastname: Sharma
mesh_terms: D000368:Aged; D002097:C-Reactive Protein / Q000032:analysis; D003324:Coronary Artery Disease / Q000401:mortality* / Q000628:therapy; D003920:Diabetes Mellitus / Q000453:epidemiology*; D005260:Female; D005500:Follow-Up Studies; D006442:Glycated Hemoglobin / Q000032:analysis; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009203:Myocardial Infarction / Q000453:epidemiology*; D009518:New York / Q000453:epidemiology; D062645:Percutaneous Coronary Intervention; D012042:Registries; D012189:Retrospective Studies; D018570:Risk Assessment; D012737:Sex Factors
chemical_list: D002097:C-Reactive Protein; D006442:Glycated Hemoglobin; C517652:hemoglobin A1c protein, human