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Gender-specific cardiovascular outcomes in patients undergoing percutaneous coronary intervention in Chinese
Juan Long1, Fanfang Zeng1, Lili Wang1
1Department of Cardiology, Fuwai Hospital Chinese Academy Science of Medical Science, Shenzhen, China.
Insights
Female patients with coronary heart disease (CHD) undergoing percutaneous coronary intervention (PCI) face higher risks for in-hospital and 30-day composite outcomes. These increased risks are primarily linked to socioeconomic status (SES) disparities compared to male patients.
Area of Science:
- Cardiology
- Interventional Cardiology
- Health Outcomes Research
Background:
- Limited data exists on gender-based differences in outcomes for patients with coronary heart disease (CHD) undergoing percutaneous coronary intervention (PCI).
- Understanding these disparities is crucial for optimizing patient care and treatment strategies.
Purpose of the Study:
- To compare in-hospital and 30-day composite outcomes between male and female patients with CHD undergoing PCI.
- To identify factors, particularly socioeconomic status (SES), influencing gender-outcome associations.
Main Methods:
- Retrospective analysis of 672 CHD patients undergoing PCI between January and December 2018.
- Comparison of baseline characteristics and clinical outcomes by gender.
- Evaluation of factors influencing gender-outcome associations, including SES.
Main Results:
- Females were older, more likely to be obese, and had higher hypertension rates than males.
- Females experienced longer hospital stays, higher in-hospital bleeding rates, and increased 30-day non-fatal myocardial infarction.
- Female gender was independently associated with higher in-hospital and 30-day composite outcomes post-PCI, with SES being a significant contributing factor.
Conclusions:
- Female patients undergoing PCI for CHD have a significantly higher risk of adverse in-hospital and 30-day outcomes compared to males.
- Socioeconomic status disparities play a major role in the observed gender-outcome association.
- Addressing SES differences is critical for improving outcomes in female PCI patients.
Background:
Data was limited on the rates of in-hospital and 30-days composite outcomes between male and female patients with coronary heart disease (CHD) undergoing percutaneous coronary intervention (PCI).
Methods:
This was a retrospective study and CHD patients undergoing PCI between January and December of 2018 were screened and recruited. Baseline characteristics, in-hospital and 30-days composite outcomes were compared by gender. The factors influencing gender-outcome associations were evaluated.
Results:
A total of 672 CHD patients undergoing PCI were included into current analysis. Compared to males, females were older (53.8 ± 12.7 years vs 50.6 ± 11.8 years), more likely to be obese (32.9% vs 29.4%) and had higher prevalence of hypertension (46.7% vs 41%). Females were less likely to be smoker (30.3% vs 1.1%), have prior history of CHD (4.4% vs 10.9%), and lower socioeconomic status [SES; full-time employment (64.4% vs 71.9%), education attainment ≥ college (29.6% vs 36.8%) and annual income ≥60,000 RMB (23.7% vs 27.1%)]. Hospitalized stay was longer in females (median 5.2 vs 4.0 days), and females were more likely to experience in-hospital bleeding (3.0% vs 1.2%) and 30-days non-fatal myocardial infarction (5.9% vs 2.9%). In unadjusted model, compared to males, females had a crude odds ratio (OR) of 2.05 (95% confidence interval [CI] 1.68-2.59) for in-hospital composite outcomes and 2.16 (95% CI 1.74-2.63) for 30-days post-PCI composite outcomes. After adjustment for potential covariates, female gender remains independently associated with in-hospital and 30-days post-PCI composite outcomes. OR change was the greatest with adjustment for SES when compared to other covariates.
Conclusion:
Compared to male patients, female patients had a higher risk of in-hospital and 30-days composite outcomes post-PCI treatment, which were mainly attributed to the differences in SES.
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