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Gender Differences in Outcomes and Predictors of All-Cause Mortality After Percutaneous Coronary Intervention (Data from United Kingdom and Sweden)

Lookup NU author(s): Dr Vijay Kunadian, Dr Hannah Sinclair

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Abstract

To determine gender differences and predictors of all-cause mortality (30 days and 1 year) after percutaneous coronary intervention (PCI) in patients with stable angina pectoris and acute coronary syndrome (non ST-elevation myocardial infarction/unstable angina pectoris and ST-elevation myocardial infarction) in the British Cardiovascular Intervention Society (BCIS) and Swedish Coronary Angiography and Angioplasty Registry (SCAAR) data sets, an analysis of prospectively collected data from 2007 to 2011 was performed. In total, 458,261 patients (BCIS: n = 368,492 [25.9% women]; Sweden: n = 89,769 [27.2% women]) who underwent PCI were included in this analysis. Using multiple regression analysis, in the BCIS registry, female gender was an independent predictor of all-cause mortality at 30 days (odds ratio [OR] 1.15, 95% CI 1.10 to 1.22, p <0.0001) and at 1 year (OR 1.08, 95% CI 1.04 to 1.12, p <0.0001) after PCI for all patients. Likewise, in the SCAAR registry, female gender was an independent predictor of all-cause mortality at 30 days (OR 1.15, 95% CI 1.05 to 1.26, p = 0.002) and 1 year (OR 1.09, 95% CI 1.03 to 1.17, p = 0.006) after PCI for all patients. In both data sets, there was no statistically significant interaction between age and gender for all-cause mortality at 30 days (BCIS, p = 0.59; SCAAR, p = 0.40) and at 1 year (BCIS, p = 0.11; SCAAR, p = 0.83). In conclusion, despite advances in care, women compared with men continue to experience higher all cause mortality after PCI for coronary artery disease. The patient's age at the time of PCI remains a strong predictive factor of mortality in this population. Strategies and further research are warranted to better address the management of coronary artery disease in women with possibly earlier diagnosis and more tailored treatments.


Publication metadata

Author(s): Kunadian V, Qiu WL, Lagerqvist B, Johnston N, Sinclair H, Tan Y, Ludman P, James S, Sarno G, National Institute for Cardiovascular Outcomes Research and Swedish Coronary Angiography

Publication type: Article

Publication status: Published

Journal: American Journal of Cardiology

Year: 2017

Volume: 119

Issue: 2

Pages: 210-216

Print publication date: 15/01/2017

Online publication date: 07/10/2016

Acceptance date: 27/09/2016

ISSN (print): 0002-9149

ISSN (electronic): 1879-1913

Publisher: Elsevier Inc.

URL: https://doi.org/10.1016/j.amjcard.2016.09.052

DOI: 10.1016/j.amjcard.2016.09.052


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