Sex Differences in Percutaneous Coronary Intervention-Insights From the Coronary Angiography and PCI Registry of the German Society of Cardiology.

Abstract

BACKGROUND:

Several studies have suggested sex-related differences in diagnostic and invasive therapeutic coronary procedures.

METHODS AND RESULTS:

Data from consecutive patients who were enrolled in the Coronary Angiography and PCI Registry of the German Society of Cardiology were analyzed. We aimed to compare sex-related differences in in-hospital outcomes of patients undergoing percutaneous coronary intervention (PCI) for stable coronary artery disease, non-ST elevation acute coronary syndromes, ST elevation myocardial infarction, and cardiogenic shock. From 2007 until the end of 2009 data from 185 312 PCIs were prospectively registered: 27.9% of the PCIs were performed in women. Primary PCI success rate was identical between the sexes (94%). There were no sex-related differences in hospital mortality among patients undergoing PCI for stable coronary artery disease, non-ST elevation acute coronary syndromes, or cardiogenic shock except among ST elevation myocardial infarction patients. Compared to men, women undergoing primary PCI for ST elevation myocardial infarction have a higher risk of in-hospital death, age-adjusted odds ratio (1.19, 95% CI 1.06-1.33), and risk of ischemic cardiac and cerebrovascular events (death, myocardial infarction, transient ischemic attack/stroke), (age-adjusted odds ratio 1.19, 95% CI 1.16-1.29). Furthermore, access-related complications were twice as high in women, irrespective of the indication.

CONCLUSIONS:

Despite identical technical success rates of PCI between the 2 sexes, women with PCI for ST elevation myocardial infarction have a 20% higher age-adjusted risk of death and of ischemic cardiac and cerebrovascular events. Further research is needed to determine the reasons for these differences.

• Authors: Tobias Heer, Matthias Hochadel, Karin Schmidt, Julinda Mehilli, Ralf Zahn, Karl-Heinz Kuck, Christian Hamm, Michael Böhm, Georg Ertl, Hans Martin Hoffmeister, Stefan Sack, Jochen Senges, Steffen Massberg, Anselm K Gitt, Uwe Zeymer
• Journal: Journal of the American Heart Association (J Am Heart Assoc) Vol. 6 Issue 3 (Mar 20 2017) ISSN: 2047-9980 [Electronic] England
• PMID: 28320749 (Publication Type: Journal Article)
• Copyright: © 2017 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley Blackwell.

Topics

• Acute Coronary Syndrome (surgery)
• Age Factors
• Aged
• Cardiology
• Coronary Angiography
• Coronary Artery Disease (surgery)
• Female
• Germany
• Hospital Mortality
• Humans
• Male
• Middle Aged
• Non-ST Elevated Myocardial Infarction (surgery)
• Odds Ratio
• Percutaneous Coronary Intervention (methods)
• Registries
• ST Elevation Myocardial Infarction (surgery)
• Sex Factors
• Shock, Cardiogenic (surgery)
• Societies, Medical