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Sex Differences in Baseline Characteristics Do Not Predict Early Outcomes after Percutaneous Coronary Intervention:
Andre Conradie1,2, Sinny Delacroix2, MyNgan Duong2
1Cardiology Department, Friendly Society Private Hospital, 23 Bingera Street, Bundaberg, QLD 4670, Australia.
Insights
Despite baseline differences, men and women had similar 30-day outcomes after percutaneous coronary intervention (PCI). Women experienced more bleeding but comparable rates of death and major adverse cardiac events (MACE).
Area of Science:
- Cardiovascular Medicine
- Interventional Cardiology
- Health Outcomes Research
Background:
- Significant baseline differences exist between men and women undergoing percutaneous coronary intervention (PCI).
- Understanding these differences is crucial for optimizing patient care and outcomes following PCI procedures.
Purpose of the Study:
- To investigate the impact of baseline demographic and clinical differences between men and women on early outcomes after PCI.
- To compare complication rates and 30-day adverse events in men and women undergoing PCI.
Main Methods:
- An observational study utilizing the GenesisCare Cardiovascular Outcomes Registry.
- Data from 10,989 consecutive patients undergoing PCI in 12 Australian private hospitals were analyzed.
- Outcomes included in-hospital complications, discharge, and 30-day events such as death, myocardial infarction, and major adverse cardiac events (MACE).
Main Results:
- Women comprised 23% of the study population, were older, and had higher rates of hypertension and hyperlipidaemia.
- Women presented with less complex coronary artery disease (CAD) and required fewer stents, but had a higher incidence of major bleeding.
- Despite baseline disparities, 30-day outcomes for death, myocardial infarction, target lesion revascularisation (TLR), major adverse cardiovascular events (MACE), and unplanned readmissions were similar between sexes.
Conclusions:
- While clinical presentation and disease complexity differ between men and women undergoing PCI, 30-day mortality and MACE rates are comparable.
- Women experienced a higher rate of major bleeding events post-PCI.
- Lower adherence to statins and dual antiplatelet therapy (DAPT) was noted in women.
Objective:
The effect of baseline differences between men and women on early outcomes after percutaneous coronary intervention (PCI).
Design, Setting, Participants:
This is an observational study of all participants in the GenesisCare Cardiovascular Outcomes Registry, undergoing PCI. The registry holds data for both emergency and elective procedures. Data was collected on 10,989 consecutive patients from 12 Australian Private Hospitals, including baseline demographics, co-morbidities, risk factors, PCI procedures, and lesion characteristics.
Main Outcome Measures:
Outcome was measured for complications (in-hospital death, peri-procedural myocardial infarctions, and bleeding events), at discharge and at 30-days for death, myocardial infarction, target lesion revascularisation (TLR), major adverse cardiac events (MACE), and unplanned readmissions.
Results:
Women represented 23% of the study population, were significantly older, with a higher rate of hypertension and hyperlipidaemia. Heart failure was more common in women and was associated with a significantly higher average ejection fraction than in men. Women had a lower rate of pre-existing coronary artery disease (CAD), had less complex CAD, and needed fewer stents. Periprocedural complications were similar, but major bleeding was more common in women. The 30-day outcome was similar between men and women for death, myocardial infarction, target lesion revascularisation (TLR), major adverse cardiovascular events (MACE), and unplanned readmissions.
Conclusions:
Although significant differences were observed between women and men in both clinical presentation and complexity of disease, the 30-day outcome was similar for death and MACE. Women had a higher rate of major bleeding events, and lower adherence to statins and dual antiplatelet therapy (DAPT).
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