Background:

In recent decades, a significant decline in coronary artery disease (CAD) related mortality has been seen. However, the rates of decline in mortality differ between men and women.

Aim:

The study intended to establish the influence of gender on mortality rates post a percutaneous coronary intervention (PCI) using data from a well-established multicenter registry. 

Method:

The data required for the analysis was collected from the Victorian Cardiac Outcomes Registry. Between 2013 and 2018, about 54,440 consecutive patients undergoing PCI were evaluated. The group comprised 12,805 (23.5%) women. The study included patients with non-ST-elevation acute coronary syndrome (NSTEACS), stable angina pectoris (SAP), ST-elevation myocardial infarction (STEMI) undergoing intervention. They were investigated and compared for gender-related differences.

Long-term all-cause mortality was the primary outcome.

Across all the indications female patients were noted to be older than males.

  • NSTEACS: 69 vs. 64 years

  • SAP: 71 vs. 67 years

  • STEMI: 67 vs. 61 years

Results: 

Females were more likely to exhibit age-adjusted higher rates of diabetes mellitus, p value for all <0.02. 

Renal impairment was more common in females than in males, p value for all <0.001. 

Intervention with femoral artery access was noted frequently in females, p value for all <0.001.

Across all age indications, the 30-day mortality and unadjusted in-hospital mortality were observed to be comparable between men and women.

However, the unadjusted long-term mortality rates were greater in women at 9% than in men at 7.37%; p <0.001. 

The hazard ratio, HR of 0.76 95% CI 0.66 to 0.87; p <0.001 was computed for the independent association between long-term survival and female gender. It was derived after adjusting for variables significant on univariate analysis.

Conclusion:

The study concluded that its results contraindicated previous studies and demonstrated a long-term survival advantage possessed by women undergoing PCI, despite the older age, dissimilar clinical profile, and different approach of intervention.

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Keywords

Disease Condition,Therapeutic Modality,Coronary Artery Disease,Interventional Cardiology,Myocardial Infarction,STEMI,Ischemic Heart Disease,Percutaneous Coronary Intervention

Source

https://www.ajconline.org/article/S0002-9149(21)00487-2/fulltext