Percutaneous coronary intervention in women: should management be different?

Women undergoing percutaneous coronary intervention (PCI) have poorer unadjusted outcomes as they are older and have greater comorbidity compared with men, but uncertainty remains whether gender affects outcome after these differences in clinical characteristics are taken into account. In this paper, we review recent published evidence comparing outcomes between men and women undergoing PCI. We focus on both acute coronary syndrome and nonacute coronary syndrome presentation, and the risk of bleeding and vascular access complication. We also review how gender is taken into account in recent guidelines and offer a common clinical scenario to illustrate the contemporary management strategies an interventional cardiologist should consider when performing PCI on a female patient.