What is the clinical evidence from this study?

Study design: Observational. Population: Coronary artery disease (n=10554). Intervention: Female gender vs. Male gender. Primary outcome: In-hospital mortality for all PCI (OR 2.06, 95% CI 1.40 to 3.01).

What does this research mean for the field?

Women undergoing percutaneous coronary intervention experience significantly higher in-hospital mortality compared to men, largely driven by older age, higher comorbidity burden, smaller vessel diameter, and treatment delays. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

What question did this study set out to answer?

To evaluate whether gender differences exist in clinical presentation, angiographic severity, procedural management, and clinical outcomes among patients undergoing percutaneous coronary intervention for coronary artery disease.

August 27, 2013PLoS ONEOpen Access

Are There Gender Differences in Coronary Artery Disease? The Malaysian National Cardiovascular Disease Database – Percutaneous Coronary Intervention (NCVD-PCI) Registry

Q: What are the key findings of this study?

Women undergoing percutaneous coronary intervention had a significantly higher risk of in-hospital mortality compared to men (1.99% vs 0.98%, OR 2.06), largely due to more comorbidities and treatment delays.

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Key result

Female sex is linked to ~106% higher in-hospital mortality post-PCI, driven by comorbidities and delays.

OR 2.06
95% CI 1.40 to 3.01
n=10,554

Why the study?

Are there gender differences in clinical presentation, management, and outcomes in patients with coronary artery disease undergoing PCI?

Key Points

To evaluate whether gender differences exist in clinical presentation, angiographic severity, procedural management, and clinical outcomes among patients undergoing percutaneous coronary intervention for coronary artery disease.
Analyzed multicenter registry data from the Malaysian NCVD-PCI Registry (2007–2009), comprising 1,961 women and 8,593 men undergoing percutaneous coronary intervention (PCI).
Defined significant angiographic stenosis as ≥70% lumen diameter narrowing in at least one major epicardial coronary artery and tracked in-hospital and 6-month mortality.
Women had significantly higher in-hospital mortality than men for all PCI (1.99% vs 0.98%; OR: 2.06, 95% CI: 1.40–3.01), STEMI (6.19% vs 2.88%; OR: 2.23, 95% CI: 1.31–3.79), and NSTEMI (2.90% vs 0.79%; OR: 3.75, 95% CI: 1.58–8.90).
Women presented with higher rates of left main stem disease (1.3% vs 0.6%, p<0.003), vessel diameters <3.0 mm (45.5% vs 34.8%, p<0.001), and longer STEMI hospital transfer times (300.4 min vs 166.3 min, p<0.039).
Adjusted six-month mortality ORs for women were 2.18 (95% CI: 0.97–4.90) for all PCI, 2.68 (95% CI: 0.37–19.61) for STEMI, and 2.66 (95% CI: 0.73–9.69) for NSTEMI.

Study Design

Type

Observational (n=10,554)

Multicenter

Yes

Structured PICO

Are there gender differences in clinical presentation, management, and outcomes in patients with coronary artery disease undergoing PCI?

Population

10,554 patients aged 18 years and older with coronary artery disease who underwent percutaneous coronary intervention, followed for up to 6 months.

Exposure

Female gender

Comparator

Male gender

Outcome

In-hospital mortality and six-month mortalityhard clinical

Main Result

Odds Ratio: 2.06 (95% CI 1.4–3.01)

Absolute Event Rate: 1.99% vs 0.98%

Women undergoing PCI have higher in-hospital and six-month mortality compared to men, largely driven by more comorbidities, smaller vessels, and longer treatment delays.

Limitations

Non-randomised observational study subjected to potential bias
Loss to follow-up due to patient movement or transfer
Findings may not generalize to all patients with coronary artery disease as it was limited to those undergoing PCI
Angiographic interpretation was based on semi-quantitative clinical reports rather than a blinded core laboratory
Small study population leading to wide confidence intervals

Discussion

No takes yet. Share an insight, caveat, or question.

Implication

Supports heightened vigilance for women undergoing PCI; leaves open whether addressing delays and comorbidities narrows outcome gaps.

Cite This Study

Lee et al. (2013) conducted an observational in Coronary artery disease (n=10,554). Female gender vs. Male gender was evaluated on In-hospital mortality for all PCI (OR 2.06, 95% CI 1.40 to 3.01). Women undergoing percutaneous coronary intervention had a significantly higher risk of in-hospital mortality compared to men (1.99% vs 0.98%, OR 2.06), largely due to more comorbidities and treatment delays.

synapsesocial.com/papers/6aa93dbcf8b27f8ac662f02f https://doi.org/10.1371/journal.pone.0072382

Topics

Coronary artery disease Women and heart disease

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Are There Gender Differences in Coronary Artery Disease? The Malaysian National Cardiovascular Disease Database – Percutaneous Coronary Intervention (NCVD-PCI) Registry

Key Points

Study Design

Structured PICO

Main Result

Limitations

Discussion

Implication

Cite This Study

Topics

Are There Gender Differences in Coronary Artery Disease? The Malaysian National Cardiovascular Disease Database – Percutaneous Coronary Intervention (NCVD-PCI) Registry

Key Points

Study Design

Structured PICO

Main Result

Limitations

Discussion

Implication

Cite This Study

Also Consider

Topics

Also Consider