Gender differences of in-hospital outcomes in patients undergoing percutaneous coronary intervention in the drug-eluting stent era

Abstract

Most studies on gender difference of the in-hospital outcome of percutaneous coronary intervention (PCI) were performed in the predrug- eluting stents (DES) era. This study was performed to investigate whether gender influences the in-hospital outcome of PCI in the DES era. A total of 44,967 PCI procedure between January and December of 2014 from the nationwide PCI registry database in Korea were analyzed. The study population was male predominant (70.2%). We examined the association of gender with unadjusted and adjusted in-hospital mortality and composite events of PCI, including mortality, nonfatal myocardial infarction, stent thrombosis, stroke, urgent repeat PCI and bleeding requiring transfusion. Most of the study patients (91.3%) received DES. The incidence rates of in-hospital mortality (2.95% vs 1.99%, P<. 001) and composite events (7.01% vs 5.48%, P<. 001) were significantly higher in women compared to men. Unadjusted analyses showed that women had a 1.49 times higher risk of in-hospital mortality and a 1.30 times higher risk of composite events than men (P<. 001 for each). After adjustment for potential confounders, female gender was not a risk factor for mortality (P=. 258), but the risk of composite events remained 1.20 times higher in women than in men (P=. 008). Among patients undergoing PCI in the contemporary DES era, female gender was associated with an increased risk of in-hospital composite events, but not in-hospital mortality. More careful attention should be emphasized to minimize procedure-related risks and to improve prognosis in women undergoing PCI.