Persistent sex difference in hospital outcome following percutaneous coronary intervention: Results from the New York State reporting system

V. S. Srinivas, Sangeeta Garg, Abdissa Negassa, Ji Yon Bang, E. Scott Monrad

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Abstract

BACKGROUND: Although sex-related differences in early outcomes have been observed in young women following acute myocardial infarction (AMI) and coronary bypass surgery, evidence for similar differences following percutaneous coronary intervention (PCI) is lacking. METHODS: Using the 1999 to 2002 New York State PCI reporting system, we identified 11,162 men and 2,561 women aged 50 years or younger undergoing a first PCI procedure. In-hospital outcomes were compared by gender after multivariable adjustment for baseline, clinical and procedural characteristics. RESULTS: Young women undergoing an initial PCI procedure were more likely to belong to racial or ethnic minorities and exhibit more comorbidities than young men. However, they had better ejection fraction (52.9% ± 11.3 vs. 51.9 + 11; p = 0.0002) and presented more often with single-vessel disease (75% vs. 67%; p < 0.0001). Despite women receiving glycoprotein IIb/IIIa inhibitors (58.6% vs. 65.1%; p < 0.0001) and stents (92.5% vs. 94.9%; p < 0.0001) less often, procedural success was achieved equally (97% vs. 96%). Young women experienced higher rates of in-hospital mortality (0.70% vs. 0.22%; p < 0.0001), and vascular damage (0.82% vs. 0.24%; p < 0.0001) compared to men. In multivariable analysis, female sex independently predicted in-hospital mortality (OR 4.0, 95% CI: 1.9 to 8.1) after adjustment for urgency of PCI, clinical and procedural characteristics. CONCLUSION: A gender-based difference in early survival exists in young women undergoing a first PCI procedure. Further investigation into the mechanism of this higher risk is warranted.

Original languageEnglish (US)
Pages (from-to)265-268
Number of pages4
JournalJournal of Invasive Cardiology
Volume19
Issue number6
StatePublished - Jun 2007

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Percutaneous Coronary Intervention
Sex Characteristics
Hospital Mortality
Platelet Glycoprotein GPIIb-IIIa Complex
Stents
Blood Vessels
Comorbidity
Myocardial Infarction
Survival

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Persistent sex difference in hospital outcome following percutaneous coronary intervention : Results from the New York State reporting system. / Srinivas, V. S.; Garg, Sangeeta; Negassa, Abdissa; Bang, Ji Yon; Monrad, E. Scott.

In: Journal of Invasive Cardiology, Vol. 19, No. 6, 06.2007, p. 265-268.

Research output: Contribution to journalArticle

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abstract = "BACKGROUND: Although sex-related differences in early outcomes have been observed in young women following acute myocardial infarction (AMI) and coronary bypass surgery, evidence for similar differences following percutaneous coronary intervention (PCI) is lacking. METHODS: Using the 1999 to 2002 New York State PCI reporting system, we identified 11,162 men and 2,561 women aged 50 years or younger undergoing a first PCI procedure. In-hospital outcomes were compared by gender after multivariable adjustment for baseline, clinical and procedural characteristics. RESULTS: Young women undergoing an initial PCI procedure were more likely to belong to racial or ethnic minorities and exhibit more comorbidities than young men. However, they had better ejection fraction (52.9{\%} ± 11.3 vs. 51.9 + 11; p = 0.0002) and presented more often with single-vessel disease (75{\%} vs. 67{\%}; p < 0.0001). Despite women receiving glycoprotein IIb/IIIa inhibitors (58.6{\%} vs. 65.1{\%}; p < 0.0001) and stents (92.5{\%} vs. 94.9{\%}; p < 0.0001) less often, procedural success was achieved equally (97{\%} vs. 96{\%}). Young women experienced higher rates of in-hospital mortality (0.70{\%} vs. 0.22{\%}; p < 0.0001), and vascular damage (0.82{\%} vs. 0.24{\%}; p < 0.0001) compared to men. In multivariable analysis, female sex independently predicted in-hospital mortality (OR 4.0, 95{\%} CI: 1.9 to 8.1) after adjustment for urgency of PCI, clinical and procedural characteristics. CONCLUSION: A gender-based difference in early survival exists in young women undergoing a first PCI procedure. Further investigation into the mechanism of this higher risk is warranted.",
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N2 - BACKGROUND: Although sex-related differences in early outcomes have been observed in young women following acute myocardial infarction (AMI) and coronary bypass surgery, evidence for similar differences following percutaneous coronary intervention (PCI) is lacking. METHODS: Using the 1999 to 2002 New York State PCI reporting system, we identified 11,162 men and 2,561 women aged 50 years or younger undergoing a first PCI procedure. In-hospital outcomes were compared by gender after multivariable adjustment for baseline, clinical and procedural characteristics. RESULTS: Young women undergoing an initial PCI procedure were more likely to belong to racial or ethnic minorities and exhibit more comorbidities than young men. However, they had better ejection fraction (52.9% ± 11.3 vs. 51.9 + 11; p = 0.0002) and presented more often with single-vessel disease (75% vs. 67%; p < 0.0001). Despite women receiving glycoprotein IIb/IIIa inhibitors (58.6% vs. 65.1%; p < 0.0001) and stents (92.5% vs. 94.9%; p < 0.0001) less often, procedural success was achieved equally (97% vs. 96%). Young women experienced higher rates of in-hospital mortality (0.70% vs. 0.22%; p < 0.0001), and vascular damage (0.82% vs. 0.24%; p < 0.0001) compared to men. In multivariable analysis, female sex independently predicted in-hospital mortality (OR 4.0, 95% CI: 1.9 to 8.1) after adjustment for urgency of PCI, clinical and procedural characteristics. CONCLUSION: A gender-based difference in early survival exists in young women undergoing a first PCI procedure. Further investigation into the mechanism of this higher risk is warranted.

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