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Updated: Aug 30, 2026

Interventional Diagnostic Procedure: A Practical Guide for the Assessment of Coronary Vascular Function
Published on: March 15, 2022
Percutaneous coronary intervention in women
Elizabeth M Holper1, David P Faxon
1Section of Cardiology, University of Chicago, USA.
Insights
Women with cardiovascular disease face a high risk, yet often underestimate it. Contemporary percutaneous coronary intervention (PCI) shows no sex difference in outcomes, and is superior to thrombolytic therapy for acute myocardial infarction in women.
Area of Science:
- Cardiology
- Interventional Cardiology
- Women's Health
Background:
- Cardiovascular disease (CVD) is the leading cause of death for women in the U.S., with many underestimating their risk.
- Referral patterns and outcomes for women undergoing invasive cardiology procedures like percutaneous coronary intervention (PCI) have historically raised concerns about sex-based disparities.
- Initial studies on balloon angioplasty suggested poorer outcomes for women, but this review examines contemporary data.
Purpose of the Study:
- To review and analyze sex differences in demographics and outcomes for women undergoing percutaneous coronary intervention (PCI).
- To assess the current landscape of PCI utilization and effectiveness in women compared to men.
- To address concerns regarding potential sex discrepancies in referral for invasive cardiac procedures.
Main Methods:
- Review of recent clinical data and studies focusing on percutaneous coronary intervention (PCI) in women.
- Comparative analysis of demographic features and clinical presentations between men and women referred for PCI.
- Examination of outcomes data, including success rates, risks, and mortality, stratified by sex.
Main Results:
- While women referred for PCI may present with different demographic and clinical profiles than men, contemporary PCI practices show no significant sex difference in outcomes.
- Primary PCI for acute myocardial infarction in women is associated with improved mortality rates compared to thrombolytic therapy.
- Historical concerns regarding poorer outcomes for women in angioplasty have not been substantiated by recent data.
Conclusions:
- Current evidence suggests that women experience comparable outcomes to men with modern percutaneous coronary intervention (PCI) techniques.
- PCI is a viable and often superior treatment option for acute myocardial infarction in women compared to older therapies.
- Further attention to women's cardiovascular health and risk perception remains crucial, alongside equitable access to advanced treatments like PCI.
Abstract:
Cardiovascular disease is currently the leading cause of death in women in the United States, but many women underestimate this risk. The treatment of coronary syndromes with percutaneous coronary intervention (PCI) has increased steadily in the past decade, but women referred for PCI have a different profile of demographic features and clinical presentation than do their male counterparts. Concern has been raised about sex discrepancy in referral of women for invasive cardiology procedures. This may have resulted from the outcomes of initial studies of balloon angioplasty, which demonstrated decreased success and increased risk of angioplasty in women compared with men. However, more recent data have shown no sex difference in outcomes with contemporary PCI practices. Additionally, primary PCI for acute myocardial infarction in women is associated with improved mortality in women when compared to thrombolytic therapy. This review will examine the sex differences in demographics and outcomes of women undergoing PCI.
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