Outcomes After Percutaneous Coronary Intervention in Women: Are There Differences When Compared with Men?

Abstract

Despite advances in the diagnosis and treatment of coronary artery disease, there remains evidence of a disparity in the outcomes for women when compared with men. This article provides a review of the evidence for this discrepancy and discusses some of the potential contributing factors.

A Novel Predictive Model for In-Hospital Mortality Based on a Combination of Multiple Blood Variables in Patients with ST-Segment-Elevation Myocardial Infarction

“…Finally, we did not take into account any other non-laboratory clinical factors for the risk stratification of in-hospital mortality, including age and sex, cardiac function, duration of ischemia, and perioperative complications. Especially, it has been reported that there were some sex-differences in outcomes after AMI and their predictive markers [41][42][43], however, we could not tease out any sex-dependent issues due to a limited proportion of female population in our cohorts. Although our risk score model showed a performance comparable to that of the GRACE score, further research is thus needed to assess whether the other clinical factors could increase the predictive value for outcome in patients with STEMI.…”

Gender-specific 11-dehydro-thromboxane B2 levels in acute coronary syndrome and its association with clinical outcomes

“…Gender-based outcome studies in ACS patients after PCI reported vague results. These studies have shown worse in-hospital and long-term clinical outcomes among females compared with males, especially higher rates of recurrent events during long-term follow-up (Josiah and Farshid, 2019; Kurlansky et al, 2017;Rao et al, 2019;Vasudevan et al, 2018). The role of thromboxane, especially in males and females, has not been investigated.…”

“…Similarly, in our study, females showed a higher dh-TxB2 level at baseline as well as at 6 months follow-up when compared to post-PTCA males (Lopez et al, 2014). Prior studies have reported that female patients with ACS undergoing PCI differ from male participants in some baseline characteristics; females are more frequently older with a high prevalence of coronary risk factors, such as diabetes mellitus, hypertension, renal insufficiency, higher prevalence of advanced heart failure, smaller access, lower estimated glomerular filtration rate, higher CAD risk profile, and high rate of bleeding complications as compared with males (Guo et al, 2018;Johansson et al, 2017;Rao et al, 2019). The socioeconomic factor was also linked to a higher risk of recurrent events, i.e., females may delay hospital visits and revascularization therapy compare to males (Lopez et al, 2014;Kareem et al, 2018).…”

“…In our present study, although males tended to have more diabetes mellitus and were younger than female patients, older females were at a higher risk of all-cause mortality. While males were associated with a higher rate of revascularization compared to females (p < 0.001), it has been observed that there is around 10-20 years delay in the onset of CVD in females and carries more CV risks and comorbidities compared to males; it can be considered as a possible cause by explaining a higher event rate in the female gender (Liu et al, 2018;Rao et al, 2019). In our study, patients who died had confounding factors like left anterior descending artery (LAD) involvement multivessel disease and more than one comorbidity.…”

“…The female gender has been associated with poorer prognosis after coronary revascularization and has a high risk of death and MI (Josiah and Farshid, 2019;Guo et al, 2018). Some studies suggest that the female gender itself is an independent risk factor for the outcomes of CV and have persistent gender differences in outcomes after angioplasty, while other studies have demonstrated equal probabilities of occurrence of events in male and females (Kurlansky et al, 2017;Pendyala et al, 2013;Rao et al, 2019).…”