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Int J Cardiol. 2014 Sep 20;176(2):456-63. doi: 10.1016/j.ijcard.2014.07.091. Epub 2014 Aug 1.

Excess mortality in women compared to men after PCI in STEMI: an analysis of 11,931 patients during 2000-2009.

Author information

1
Thoraxcenter, Erasmus MC, Rotterdam, The Netherlands.
2
Thoraxcenter, Erasmus MC, Rotterdam, The Netherlands. Electronic address: Eh.boersma@erasmusmc.nl.

Abstract

BACKGROUND:

Ambiguity exists whether gender affects outcome in patients undergoing percutaneous coronary intervention (PCI).

METHODS:

To evaluate the relationship between gender and outcome in a large cohort of PCI patients, 11,931 consecutive patients who underwent PCI for various indications during 2000-2009 were studied using survival analyses and Cox regression models.

RESULTS:

Most patients (n=8588; 72%) were men. Women were older and more often had a history of hypertension and diabetes mellitus. Men smoked more frequently, had a more extensive cardiovascular history (previous MI, PCI and CABG), a higher prevalence of renal impairment and multi-vessel disease. In STEMI patients, women had higher 31-day mortality rates than men (11.6% vs. 6.5%, respectively, p<0.001). This difference remained after adjustment for confounders (aHR at 30-days 1.54 and 95% CI 1.22-1.96). Likewise, higher mortality was observed at 1-year (15.1% vs. 9.3%) and 4-year follow-up (21.6% vs. 15.0%, aHR 1.30 and 95% CI 1.10-1.53). There were no differences in mortality between women and men in NSTE-ACS (aHR at 4-years 1.05 and 95% CI 0.85-1.28) or stable angina (HR at 4-years 0.85 and 95% CI 0.68-1.08).

CONCLUSION:

Women undergoing PCI for STEMI had higher mortality than men. The excess mortality in women appeared in the first month after PCI and could only partially be explained by a difference in baseline characteristics. No gender differences in outcome in patients undergoing PCI for NSTE-ACS and stable angina were observed.

KEYWORDS:

Gender; Outcome; PCI; STEMI

PMID:
25127966
DOI:
10.1016/j.ijcard.2014.07.091
[Indexed for MEDLINE]
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