Key result
Female sex is linked to ~6-point higher 10-year mortality after PCI compared to men.
Why the study?
Data on potential sex differences in age-specific 10-year mortality risk in all-comer patients after PCI are scarce.
Does percutaneous coronary intervention impact the 10-year age-specific mortality risk in women and men compared to the general population?
Cohort (n=2,743)
No
Does percutaneous coronary intervention impact the 10-year age-specific mortality risk in women and men compared to the general population?
Absolute Event Rate: 29.4% vs 23.1%
p-value: p=<0.001
Ten years after PCI with new-generation drug-eluting stents, both men and women have significantly higher all-cause mortality compared to the age-matched general population, with a more pronounced relative risk increase observed in women.
Women post-PCI show excess 10-year mortality versus men and the general population; hypothesis-generating for sex-specific secondary prevention.
Aims Over time, clinical outcome after percutaneous coronary intervention (PCI) with contemporary drug-eluting stents (DES) has improved. While most patients survive for many years after PCI, data on potential sex differences in age-specific 10-year mortality risk in all-comer patients are scarce. This study aimed to examine the sex- and age-specific 10-year mortality risk after PCI with new-generation DES. Methods and results This investigator-driven study assessed women and men, enrolled in our centre in two large-scale all-comer PCI trials (TWENTE and DUTCH PEERS; ClinicalTrials.gov NCT01066650 and NCT01331707, respectively), and compared their long-term mortality risk with that of the general population. The life status was checked in a national database of personal records. Information about the causes of death was obtained from medical records. Of all 2743 patients, 220/748 women and 461/1995 men died (29.4 vs. 23.1%, respectively, P < 0.001). Deceased patients had higher cardiovascular risk profiles and were older than patients who survived. Compared to the general population of a similar age, women and men who underwent PCI showed significantly increased 10-year all-cause mortality risks with a standardized mortality ratio of 2.13 [95% confidence interval (CI): 1.85–2.41] and 1.63 (95% CI: 1.48–1.78), respectively. No sex difference in causes of death was observed (cardiac, 28.2% women vs. 30.8% men, P = 0.46; vascular, 4.1 vs. 5.4%, P = 0.45; non-cardiovascular, 38.2 vs. 44.5%, P = 0.11). Conclusion PCI patients of both sexes showed higher 10-year age-specific mortality risks than the general population with a more pronounced difference observed in women. There was no sex difference in underlying causes of death. Furthermore, both women and men who died had higher cardiovascular risk profiles than those who survived.
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Pinxterhuis et al. (2024) conducted a cohort in Coronary artery disease requiring PCI (n=2,743). Female sex vs. Male sex was evaluated on 10-year all-cause mortality (p=<0.001). Women undergoing PCI had a significantly higher 10-year all-cause mortality rate (29.4%) compared to men (23.1%), and both sexes had increased mortality compared to the general population.
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