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. 2023 Jan 25;87(2):277-286.
doi: 10.1253/circj.CJ-22-0517. Epub 2022 Nov 8.

Sex Differences in Clinical Outcomes After Percutaneous Coronary Intervention

Yasuaki Takeji  1 , Takeshi Morimoto  2 , Hiroki Shiomi  1 , Eri Toda Kato  1 , Kazuaki Imada  3 , Yusuke Yoshikawa  1 , Yukiko Matsumura-Nakano  1 , Ko Yamamoto  1 , Kyohei Yamaji  3 , Toshiaki Toyota  4 , Tomohisa Tada  5 , Junichi Tazaki  1 , Erika Yamamoto  1 , Kenji Nakatsuma  6 , Satoru Suwa  7 , Natsuhiko Ehara  4 , Ryoji Taniguchi  8 , Toshihiro Tamura  9 , Hiroki Watanabe  10 , Mamoru Toyofuku  10 , Takashi Yamamoto  11 , Eiji Shinoda  12 , Hiroshi Mabuchi  13 , Moriaki Inoko  14 , Tomoya Onodera  15 , Hiroki Sakamoto  5 , Tsukasa Inada  16 , Kenji Ando  3 , Yutaka Furukawa  4 , Yukihito Sato  8 , Kazushige Kadota  17 , Yoshihisa Nakagawa  11 , Takeshi Kimura  1   18
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Free article

Sex Differences in Clinical Outcomes After Percutaneous Coronary Intervention

Yasuaki Takeji et al. Circ J. .
Free article

Abstract

Background: There is a scarcity of studies comparing the clinical outcomes after percutaneous coronary intervention (PCI) for women and men stratified by the presentation of acute coronary syndromes (ACS) or stable coronary artery disease (CAD).

Methods and results: The study population included 26,316 patients who underwent PCI (ACS: n=11,119, stable CAD: n=15,197) from the CREDO-Kyoto PCI/CABG registry Cohort-2 and Cohort-3. The primary outcome was all-cause death. Among patients with ACS, women as compared with men were much older. Among patients with stable CAD, women were also older than men, but with smaller difference. The cumulative 5-year incidence of all-cause death was significantly higher in women than in men in the ACS group (26.2% and 17.9%, log rank P<0.001). In contrast, it was significantly lower in women than in men in the stable CAD group (14.2% and 15.8%, log rank P=0.005). After adjusting confounders, women as compared with men were associated with significantly lower long-term mortality risk with stable CAD but not with ACS (hazard ratio [HR]: 0.75, 95% confidence interval [CI]: 0.69-0.82, P<0.001, and HR: 0.92, 95% CI: 0.84-1.01, P=0.07, respectively). There was a significant interaction between the clinical presentation and the mortality risk of women relative to men (interaction P=0.002).

Conclusions: Compared with men, women had significantly lower adjusted mortality risk after PCI among patients with stable CAD, but not among those with ACS.

Keywords: Acute coronary syndrome; Coronary artery disease; Coronary revascularization; Sex differences.

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