Previous studies have reported that women have worse outcomes than men after percutaneous
coronary intervention (PCI), especially in patients with ST-elevation myocardial infarction.
However, gender-related differences in patients with non–ST-elevation acute coronary
syndromes (NSTE-ACS) have not been thoroughly investigated. In the Japanese nationwide
registry, a total of 43,239 patients with NSTE-ACS from 861 hospitals underwent PCI
in 2014. Overall, 11,326 patients (26.2%) were women. The women were older (75.0 ±
10.3 vs 68.7 ± 11.4 years, p <0.001) and had a higher prevalence of hypertension (p <0.001),
hyperlipidemia (p = 0.003), and heart failure (p <0.001) compared with men. For inpatient
outcomes, women had a higher rate of overall complications (3.3% vs 2.4%, p <0.001)
and bleeding complications that required blood transfusion (0.6% vs 0.2%, p <0.001).
On multivariate analysis, female gender was an independent predictor of overall (odds
ratio [OR] 1.20, 95% CI 1.04 to 1.38; p = 0.011) and bleeding complications (OR 1.94,
95% CI 1.35 to 2.79; p <0.001) after adjustment but was not associated with in-hospital
mortality (OR 1.05, 95% CI 0.79 to 1.40; p = 0.747). In conclusion, in patients with
NSTE-ACS who underwent PCI, women were at greater risk than men for in-hospital complications,
especially in bleeding complications.
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Article info
Publication history
Published online: December 17, 2016
Accepted:
November 17,
2016
Received in revised form:
November 17,
2016
Received:
September 27,
2016
Footnotes
See page 830 for disclosure information.
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Copyright
© 2016 Elsevier Inc. All rights reserved.