Sex Differences in Health Status and Clinical Outcomes After Nonprimary Percutaneous Coronary Intervention

Abstract

Background: Greater insight into sex-based differences in health status can lay the foundation for more equitable health care. This study compares differences in health status of women and men in the CPORT-E trial (Cardiovascular Patient Outcomes Research Team Non-Primary Percutaneous Coronary Intervention) undergoing nonprimary percutaneous coronary intervention.

Methods: We compared Seattle Angina Questionnaire scores at baseline, 6 weeks, and 9 months for 6851 women and 12 016 men undergoing nonprimary percutaneous coronary intervention.

Results: Proportions of angina-free patients increased from 26.2% and 29.8% at baseline to 71.6% and 78.7% at 6 weeks to 78.1% and 83.0% at 9 months in women and men, respectively (P<0.001 for all). After adjusting for clinical and procedural characteristics as well as baseline angina, freedom from angina in women was 34% less likely at 6 weeks (odds ratio, 0.66 [95% CI, 0.61-0.71]; P<0.001) and 32% less likely at 9 months (odds ratio, 0.68 [95% CI, 0.62-0.74]; P<0.001) compared with men.

Conclusions: Although health status increased significantly after percutaneous coronary intervention in both women and men, women had poorer health status outcomes than men before and after percutaneous coronary intervention. Additional investigation into therapies that address the causes of poorer health status in women with coronary artery disease is needed. Registration: URL: https://www.clinicaltrials.gov; Unique identifier: NCT00549796.

Keywords: United States; coronary artery disease; health status; percutaneous coronary intervention; sex.