Female sex was associated with a higher risk of major adverse cardiac events at 5 years following percutaneous coronary intervention compared with men (HR 1.14; 95% CI 1.01-1.30; p=0.04).
Meta-Analysis (n=32,877)
Yes
Does female sex independently predict worse 5-year cardiovascular outcomes in patients undergoing percutaneous coronary intervention?
In a large pooled analysis of PCI trials, female sex was an independent predictor of increased 5-year MACE and ischemia-driven target lesion revascularization compared with men.
Hazard Ratio: 1.14 (95% CI 1.01–1.3)
Absolute Event Rate: 18.9% vs 17.7%
p-value: p=0.04
BACKGROUND Studies examining sex-related outcomes following percutaneous coronary intervention (PCI) have reported conflicting results. OBJECTIVES The purpose of this study was to examine the sex-related risk of 5-year cardiovascular outcomes after PCI. METHODS The authors pooled patient-level data from 21 randomized PCI trials and assessed the association between sex and major adverse cardiac events (MACE) (cardiac death, myocardial infarction MI, or ischemia-driven target lesion revascularization ID-TLR) as well as its individual components at 5 years. RESULTS Among 32,877 patients, 9,141 (27.8%) were women. Women were older and had higher body mass index, more frequent hypertension and diabetes, and less frequent history of surgical or percutaneous revascularization compared with men. By angiographic core laboratory analysis, lesions in women had smaller reference vessel diameter and shorter lesion length. At 5 years, women had a higher unadjusted rate of MACE (18.9% vs. 17.7%; p = 0.003), all-cause death (10.4% vs. 8.7%; p = 0.0008), cardiac death (4.9% vs. 4.0%; p = 0.003) and ID-TLR (10.9% vs. 10.2%; p = 0.02) compared with men. By multivariable analysis, female sex was an independent predictor of MACE (hazard ratio HR:: 1.14; 95% confidence interval CI:: 1.01 to 1.30; p = 0.04) and ID-TLR (HR: 1.23; 95% CI: 1.05 to 1.44; p = 0.009) but not all-cause death (HR: 0.91; 95% CI: 0.75 to 1.09; p = 0.30) or cardiac death (HR: 0.97; 95% CI: 0.73 to 1.29; p = 0.85). CONCLUSIONS In the present large-scale, individual patient data pooled analysis of contemporary PCI trials, women had a higher risk of MACE and ID-TLR compared with men at 5 years following PCI.
Kosmidou et al. (Wed,) conducted a meta-analysis in Percutaneous coronary intervention (n=32,877). Female sex vs. Male sex was evaluated on Major adverse cardiac events (MACE) (cardiac death, myocardial infarction, or ischemia-driven target lesion revascularization) (HR 1.14, 95% CI 1.01 to 1.30, p=0.04). Female sex was associated with a higher risk of major adverse cardiac events at 5 years following percutaneous coronary intervention compared with men (HR 1.14; 95% CI 1.01-1.30; p=0.04).
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