Time Trends in Major Adverse Cardiovascular Events After Percutaneous Coronary Intervention: Meta-Analysis on Sex...

Area of Science:

• Cardiology
• Interventional Cardiology
• Sex Differences in Medicine

Background:

• Percutaneous coronary intervention (PCI) is a standard treatment for acute coronary syndrome (ACS), aiming to improve cardiovascular outcomes.
• Existing research presents conflicting results regarding potential sex-based differences in PCI outcomes, necessitating further investigation.
• Understanding these disparities is crucial for optimizing patient care and treatment strategies.

Purpose of the Study:

• To conduct a meta-analysis evaluating sex-related differences in cardiovascular adverse outcomes following PCI in patients with ACS.
• To specifically examine major adverse cardiovascular events (MACE) and their components.
• To assess outcomes across short-term, mid-term, and long-term follow-up periods.

Main Methods:

• A systematic meta-analysis was performed, pooling data from 32 relevant clinical trials.
• Risk ratios (RR) and 95% confidence intervals (CIs) were calculated using a random effects model.
• Outcomes including MACE, all-cause mortality, myocardial infarction, cardiovascular mortality, stroke, and repeat revascularization were analyzed at different time points.

Main Results:

• Short-term analysis revealed higher risks for women in MACE (RR: 1.43), all-cause mortality (RR: 2.51), and myocardial infarction (RR: 1.33) compared to men.
• Long-term follow-up showed increased risks for women in MACE (RR: 1.11), all-cause mortality (RR: 1.29), and cardiovascular mortality (RR: 1.30).
• No significant sex differences were observed for stroke or repeat revascularization in either the short or long term.

Conclusions:

• This meta-analysis indicates that women experience a higher risk of adverse cardiovascular outcomes after PCI for ACS compared to men.
• The findings underscore the importance of considering sex as a biological variable in the management and outcomes of PCI.
• Further research is warranted to elucidate the underlying mechanisms driving these observed sex differences.