Acute Complications and Restenosis in Women Undergoing Percutaneous Transluminal Coronary Angioplasty. Is it Possible to Define Sex Differences and to Determine Risk Factors?

BACKGROUND: Several investigators report a sex bias in the treatment of coronary artery disease. This study attempts to define sex differences in the outcome of percutaneous transluminal coronary angioplasty (PTCA) and to determine risk factors contributing to these results. RESULTS: Data were collected from 1082 patients (887 men and 195 women). In women, the risk of abrupt vessel closure (8.1% versus 2.5%, odds ratio 3.46) and of myocardial infarction (6.2% versus 1.2%, odds ratio 5.58) following PTCA for stable angina pectoris was significantly increased. History of myocardial infarction and PTCA of a vessel of less than 3.0 mm diameter predicted abrupt vessel closure in women. Age and cardiovascular risk factors were not predictors. The incidence of restenosis did not differ significantly (angiographic restenosis in women 36.1% versus 40.8% in men, P=0.34). CONCLUSIONS: A significantly increased risk of acute complications could only be documented in women undergoing PTCA for stable angina pectoris and not in acute coronary syndrome. Long-term outcome was similar between the two sexes.