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Medicine (Baltimore). 2019 May;98(20):e15557. doi: 10.1097/MD.0000000000015557.

Gender differences of in-hospital outcomes in patients undergoing percutaneous coronary intervention in the drug-eluting stent era.

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Division of Cardiology, Boramae Medical Center, Seoul National University College of Medicine, Seoul.
Division of Cardiology, Busan Paik Hospital, University of Inje College of Medicine, Busan.
Division of Cardiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul.
Cardiovascular Center, Seoul National University Bundang Hospital and Seoul National University College of Medicine, Seongnam.
Department of Cardiology, Ajou University School of Medicine, Suwon.
Department of Cardiology, Chungnam National University School of Medicine, Chungnam National University Hospital, Daejeon.
Division of Cardiology, Seoul St. Mary's Hospital, The Catholic University of Korea, Seoul.
Department of Internal Medicine and Heart Center, Chonnam National University Hospital, Gwangju.
Division of Cardiology, Mediplex Sejong General Hospital, Incheon.
Division of Cardiology, Severance Cardiovascular Hospital, Yonsei University College of Medicine.
Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea.


Most studies on gender difference of the in-hospital outcome of percutaneous coronary intervention (PCI) were performed in the pre-drug-eluting stents (DES) era. This study was performed to investigate whether gender influences the in-hospital outcome of PCI in the DES era.A total of 44,967 PCI procedure between January and December of 2014 from the nationwide PCI registry database in Korea were analyzed. The study population was male predominant (70.2%). We examined the association of gender with unadjusted and adjusted in-hospital mortality and composite events of PCI, including mortality, nonfatal myocardial infarction, stent thrombosis, stroke, urgent repeat PCI and bleeding requiring transfusion.Most of the study patients (91.3%) received DES. The incidence rates of in-hospital mortality (2.95% vs 1.99%, P <.001) and composite events (7.01% vs 5.48%, P <.001) were significantly higher in women compared to men. Unadjusted analyses showed that women had a 1.49 times higher risk of in-hospital mortality and a 1.30 times higher risk of composite events than men (P <.001 for each). After adjustment for potential confounders, female gender was not a risk factor for mortality (P = .258), but the risk of composite events remained 1.20 times higher in women than in men (P = .008).Among patients undergoing PCI in the contemporary DES era, female gender was associated with an increased risk of in-hospital composite events, but not in-hospital mortality. More careful attention should be emphasized to minimize procedure-related risks and to improve prognosis in women undergoing PCI.

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