TY - JOUR
T1 - Excess mortality in women compared to men after PCI in STEMI
T2 - An analysis of 11,931 patients during 2000-2009
AU - De Boer, Sanneke P.M.
AU - Roos-Hesselink, Jolien W.
AU - Van Leeuwen, Maarten A.H.
AU - Lenzen, Mattie J.
AU - Van Geuns, Robert Jan
AU - Regar, Evelyn
AU - Van Mieghem, Nicolas M.
AU - Van Domburg, Ron
AU - Zijlstra, Felix
AU - Serruys, Patrick W.
AU - Boersma, Eric
N1 - Publisher Copyright:
© 2014 Elsevier Ireland Ltd. All rights reserved.
PY - 2014
Y1 - 2014
N2 - 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.Womenwere 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 highermortality than men. The excess mortality inwomen 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.
AB - 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.Womenwere 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 highermortality than men. The excess mortality inwomen 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.
KW - Gender
KW - Outcome
KW - PCI
KW - STEMI
UR - http://www.scopus.com/inward/record.url?scp=84922402592&partnerID=8YFLogxK
U2 - 10.1016/j.ijcard.2014.07.091
DO - 10.1016/j.ijcard.2014.07.091
M3 - Article
C2 - 25127966
AN - SCOPUS:84922402592
SN - 0167-5273
VL - 176
SP - 456
EP - 463
JO - International Journal of Cardiology
JF - International Journal of Cardiology
IS - 2
ER -
