Sex-based Differences in Complications Following Percutaneous Coronary Interventions

The role that sex plays in the incidence and outcomes of PCI related complications is not well understood. The purpose of this review is to highlight the commonly encountered peri-procedural complications and search for any sex differences in the published literature.

Procedure related complications and long-term cardiovascular outcomes remain worse in women. The delayed presentation of women with coronary events and delayed referral for an invasive diagnostic angiogram and subsequent revascularization likely contribute to the worse outcomes. Whether the smaller vessel size, residual Syntax Score, and other biological factors impact periprocedural outcomes is controversial and warrants device and procedure specific research to identify sex differences. Modern day percutaneous revascularization has achieved very high acute procedural success rates and low complication rates with the advent of structured training programs, development of appropriate use criteria and refined devices and technologies in the catheterization laboratory. However, both procedure related complications and long-term cardiovascular outcomes remain worse in women.