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gender outcomes PCI

Outcome Differences Among Genders Following Percutaneous Coronary Intervention

March 20, 2017

Key Takeaways

  • Gender disparities exist in the treatment of patients with cardiovascular disease, with women experiencing a greater impact.
  • Female gender was consistently shown in this study to be an independent predictor of all-cause mortality at 30 days and 1 year. The greater comorbidities of the female population and potential bias in treatment strategies were theorized to play a role in the researchers’ findings.

Gender disparities in the treatment of cardiovascular disease has been consistently reported, a fact that has resulted in significant differences in treatment outcomes. Despite the advances of interventional cardiology techniques, there is still noticeable differences in treatment characteristics and results between genders. Typically, women have been greatly impacted by gender-associated treatment discrepancies, particularly when it comes to mortality outcomes following interventional cardiology procedures.

An observational, prospective cohort study published in the American Journal of Cardiology reviewed data from the British Cardiovascular Intervention Society (BCIS) and Swedish Coronary Angiography and Angioplasty Registry (SCAAR) data sets which included women and men receiving percutaneous coronary intervention (PCI).1 Specifically, researchers Kunadian V et al evaluated the gender differences in relation to predictors and outcomes of all-cause mortality among patients (N=458,261) receiving PCI for coronary artery disease (CAD).

Baseline characteristics, including age and incidence of diabetes mellitus, hypertension, and hypercholesterolemia, were significantly different between men and women. Overall, women had more comorbidities and were older than men, all of which are predictors for treatment outcomes. The unadjusted all-cause mortality was higher for women than men at both 30 days and 1 year following PCI in BCIS, but only higher for female patients in the SCAAR registry in the setting of non-ST-elevation myocardial infarction (NSTEMI).

Female gender was consistently shown to be an independent predictor of all-cause mortality at 30 days and 1 year after using a multiple regression analysis. The choice of procedure as well as associated complications are two possible explanations for the higher all-cause mortality findings. Femoral procedures, for instance, were performed more often for women than men, which may have played a role in outcomes results. Also, there was a statistically significant higher incidence of blood transfusion among women, indicating greater bleeding complications following the chosen procedure.

Reference:

  1. Kunadian V, Qiu W, Lagerqvist B, et al. Gender Differences in Outcomes and Predictors of All-Cause Mortality After Percutaneous Coronary Intervention (Data from United Kingdom and Sweden). Am J Cardiol. 2017;119(2):210-216.
  2. Haynes AB, Weiser TG, Berry WR, et al. A surgical safety checklist to reduce morbidity and mortality in a global population. N Engl J Med. 2009;360(5):491-499.ui

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