Female sex was independently associated with a lower long-term risk of MACE compared to men after PCI (58.0% vs 65.3%; adjusted HR 0.69-0.82, P<0.001).
Cohort (n=136,109)
Yes
Does female sex improve long-term clinical outcomes compared to male sex in patients undergoing percutaneous coronary intervention?
In a large Asian cohort, women undergoing PCI experienced higher rates of in-hospital complications but had a significantly lower long-term risk of MACE compared to men.
Effect estimate: HR 0.69-0.82
Absolute Event Rate: 58% vs 65.3%
p-value: p=<0.001
BACKGROUND: Sex differences in outcomes after percutaneous coronary intervention (PCI) remain debated, and evidence from large Asian populations is limited. METHODS: We analyzed 136 109 patients (101 301 men; 34 808 women) without prior major cardiovascular events who underwent PCI between 2004 and 2020, using data from the Korean National Health Insurance Service. Baseline characteristics, in-hospital events, and long-term clinical outcomes were compared. The primary endpoint was major adverse cardiovascular events (MACE), defined as a composite of all-cause death, nonfatal myocardial infarction, repeat PCI, coronary artery bypass surgery, and ischemic stroke. RESULTS: Women were older and had higher rates of hypertension and diabetes, whereas men had higher smoking and alcohol consumption rates. In-hospital adverse events, including death, ischemic stroke, and bleeding were more frequent in women (P < 0.001). However, during a mean follow-up of 3.1 years, women had a lower incidence of MACE compared to men (58.0 vs. 65.3%; P < 0.001). Multivariable Cox regression confirmed that female sex was independently associated with a lower long-term risk of MACE (adjusted hazard ratio: 0.69-0.82, P < 0.001). CONCLUSION: Despite worse in-hospital outcomes, women had a more favorable long-term prognosis after PCI compared to men. These findings emphasize the importance of sex-specific approaches in risk assessment and long-term management after PCI.
Kim et al. (Tue,) conducted a cohort in Percutaneous coronary intervention (PCI) (n=136,109). Female sex vs. Male sex was evaluated on Major adverse cardiovascular events (MACE), defined as a composite of all-cause death, nonfatal myocardial infarction, repeat PCI, coronary artery bypass surgery, and ischemic stroke (HR 0.69-0.82, p=<0.001). Female sex was independently associated with a lower long-term risk of MACE compared to men after PCI (58.0% vs 65.3%; adjusted HR 0.69-0.82, P<0.001).