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Gender discrepancy reported in outcomes, correlates for outcomes after PCI
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New data suggest that there are gender differences in clinical outcomes after PCI, as well as different correlates for those outcomes, that should be taken into account when women undergo the procedure.
The study included 6,929 consecutive patients (35.7% women) with ACS reviewed from a registry from 2000 to November 2010.
At 1 year, the unadjusted rates of all-cause mortality (10.7% vs. 7.5%; P<.001) and MACE (16.4% vs. 12.7%; P<.001) were higher in women. At 1, 6 and 12 months, women had worse ischemic outcomes.
Multivariate proportional-hazards regression models showed a stark difference in 1-year mortality. In women, chronic renal insufficiency (HR=2.7; 95% CI, 1.86-3.9), diabetes (HR=1.88; 95% CI, 1.29-2.73), type C lesion (HR=1.61; 95%, CI 1.14-2.28) and age per 10-year increment (HR=1.43; 95% CI, 1.21-1.7) were the strongest predictors. In men, chronic renal insufficiency (HR=2.3; 95% CI 1.68-3.15), diabetes (HR=1.61, 95% CI, 1.19-2.17), current smoking (HR=1.86; 95% CI 1.31-2.63), age (HR=1.58; 95% CI 1.36-1.84) and peripheral arterial disease (HR=1.56; 95% CI 1.13-2.14) were the strongest predictors.
Researchers wrote that these gender-based differences should be taken into account when women undergo PCI.
“We agree with current guideline recommendations that both genders should be evaluated and treated in the same way, but it is critical to understand the underlying reasons for the gender-based differences in outcomes after PCI and to optimize therapy on the basis of these differences,” they wrote.
Disclosure: The researchers report no relevant financial disclosures.
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