Women experience better long-term outcomes after PCI
Women undergoing percutaneous coronary intervention (PCI) have a long-term survival edge compared to men, according to new data published in The American Journal of Cardiology. However, they routinely receive fewer evidence-based therapies for coronary artery disease (CAD) and undergo PCI less frequently than men.
First author Alexandra C. Murphy, MBBS, of the department of cardiology at Austin Health in Melbourne, Australia, and colleagues examined the impact of gender on long-term mortality following PCI stratified by clinical presentation.
The authors analyzed data from more than 54,000 patients who underwent PCI from 2013 to 2018. All data came from the Victorian Cardiac Outcomes Registry, and 76.5% of patients were men.
“We aimed to compare gender-related differences of patients undergoing PCI for stable angina pectoris (SAP), non-ST-elevation acute coronary syndrome (NSTEACS) and ST-elevation myocardial infarction (STEMI)," Murphy and colleagues wrote. "The primary outcome was long-term all-cause mortality."
The team found that female patients across all indications were older, had higher rates of diabetes mellitus and were more likely to present with renal dysfunction, while male patients were more likely to have a past history of ischemic heart disease, peripheral vascular disease and present with left ventricular dysfunction.
According to the authors, unadjusted in-hospital and 30-day mortality rates were similar between men and women across all indications. In contrast to men, women had a higher rate of unadjusted long-term mortality (9.0% vs 7.37%).
After adjusting for certain variables, however, women were independently associated with improved long-term survival after undergoing PCI.
“The implementation of guide-line-directed management in women with CAD is a public health priority and further studies examining their unique pathophysiology are needed to better understand this paradox,” Murphy and colleagues wrote.
The full analysis is available here.