Female sex was associated with higher unadjusted 5-year rates of death, MI, and TVR compared to men (30.72% vs 24.65%, P<0.001), but was not an independent predictor after adjusting for comorbidities.
Cohort (n=5,819)
Does female sex independently predict worse long-term clinical outcomes in patients with ACS undergoing emergent PCI?
Worse long-term outcomes in women following emergent PCI for ACS are driven by older age and higher rates of comorbidities rather than female sex itself.
Absolute Event Rate: 30.72% vs 24.65%
p-value: p=<0.001
OBJECTIVES: Recent literature shows a greater risk for adverse clinical outcomes following acute coronary syndrome (ACS) events in women undergoing a percutaneous coronary intervention (PCI), especially in young and diabetic patients. We aimed to assess the impact of sex on clinical results following ACS. METHODS: From our database of all-comer PCI patients, between 1 April 2004 and 31 December 2011, the procedural and angiographic results and clinical outcomes up to 5 years of 5819 patients with ACS undergoing emergent PCI were analyzed and compared according to sex. RESULTS: A total of 1425 (24.5%) of the patients were women. They presented at an older age (72.7±11.3 vs. 65.2±12.3 years, P<0.001), and more had diabetes mellitus (46.7 vs. 40.0%, P<0.001) and previous heart failure (12.1 vs. 7.26%, P=0.001). Mortality (21.63 vs. 13.22% at 5 years, P<0.001) and combined endpoints of death, myocardial infarction, and target-vessel revascularization (30.72 vs. 24.65% at 5 years, P<0.001) were higher in women. In a multivariate analysis using age, previous diabetes, heart failure, coronary artery bypass graft surgery, baseline glomerular filtration rate, presentation with ST-elevation myocardial infarction, and proximal left anterior descending artery disease, female sex was no longer an independent predictor of outcomes. No sex differences in mortality or major adverse cardiac events were observed in young or diabetic patients. CONCLUSION: Our results show no sex differences in clinical endpoints among ACS patients undergoing PCI after correction for advanced age and comorbidities. Importantly, no differences were found in patients with diabetes mellitus or those younger than 60 years of age. This may reflect the importance of the administration of evidence-based therapeutics in women.
Perl et al. (Thu,) conducted a cohort in Acute coronary syndrome (n=5,819). Female sex vs. Male sex was evaluated on Combined endpoints of death, myocardial infarction, and target-vessel revascularization (p=<0.001). Female sex was associated with higher unadjusted 5-year rates of death, MI, and TVR compared to men (30.72% vs 24.65%, P<0.001), but was not an independent predictor after adjusting for comorbidities.
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