1. Female gender and mortality after percutaneous coronary intervention: results from a large registry.
- Author
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Kovacic JC, Mehran R, Karajgikar R, Baber U, Suleman J, Kim MC, Krishnan P, Dangas G, Sharma SK, and Kini A
- Subjects
- Aged, Aged, 80 and over, Chi-Square Distribution, Cholesterol, HDL blood, Cholesterol, LDL blood, Comorbidity, Coronary Artery Disease blood, Coronary Artery Disease ethnology, Coronary Artery Disease mortality, Diabetes Mellitus ethnology, Diabetes Mellitus mortality, Female, Hospitals, High-Volume, Humans, Hypertension ethnology, Hypertension mortality, Logistic Models, Male, Middle Aged, Minority Groups, Multivariate Analysis, New York epidemiology, Odds Ratio, Percutaneous Coronary Intervention adverse effects, Propensity Score, Registries, Retrospective Studies, Risk Assessment, Risk Factors, Sex Factors, Smoking adverse effects, Smoking ethnology, Smoking mortality, Treatment Outcome, Coronary Artery Disease therapy, Health Status Disparities, Percutaneous Coronary Intervention mortality
- Abstract
Objectives: To investigate if previously reported gender-based outcome disparities following percutaneous coronary intervention (PCI) are applicable in a large and racially-diverse cohort in the drug eluting stent (DES) era., Background: It is generally believed that women suffer inferior outcomes compared to men after PCI. However, various strategies have evolved that may have mitigated this imbalance, including improved medical therapy, attention to risk-factors, and procedural advances of PCI including DES., Methods: We identified 13,752 patients (4,761 female, 34.6%) with complete follow-up data who underwent de novo lesion PCI from 04/2003 to 04/2009. Relevant data were extracted from an IRB-approved registry., Results: Compared to males, females were significantly older (69.0 vs. 64.8 years) and more frequently from a minority or non-Caucasian background. Females smoked less, but more were hypertensive and/or diabetic. Women had higher HDL, but also higher LDL cholesterol levels. More women presented with an unstable coronary syndrome and required left anterior descending artery PCI. While unadjusted post-PCI mortality rates were higher in females versus males (30 days, 1.3 vs. 0.8%, P = 0.009; 1 year, 6.1 vs. 4.8%, P = 0.001; 3 year, 10.4 vs. 8.4%, P < 0.0001), multivariable regression analyses failed to identify female gender as an independent predictor of mortality. Propensity-adjusted modeling confirmed that females were not at intrinsically higher risk for mortality after PCI., Conclusions: Females undergoing PCI exhibit more comorbidities and adverse prognostic factors than males. However, risk-adjusted analyses identified that gender is not an independent predictor of mortality after PCI in the DES era., (Copyright © 2011 Wiley Periodicals, Inc.)
- Published
- 2012
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