Sex-Based Differences in Clinical Practice and Outcomes for Japanese Patients With Acute Myocardial Infarction Undergoing Primary Percutaneous Coronary Intervention

Takahashi, Toshiaki; Furukawa, Yutaka; Ehara, Natsuhiko; Funakoshi, Shunsuke; Morimoto, Takeshi; Kaji, Shuichiro; Nakagawa, Yoshihisa; Kadota, Kazushige; Iwabuchi, Masashi; Shiomi, Hiroki; Yamamuro, Atsushi; Kinoshita, Makoto; Kitai, Takeshi; Kim, Kitae; Tani, Tohru; Kobori, Atsushi; Kita, Toru; Sakata, Ryuzo; Kimura, Takeshi

doi:10.1253/circj.cj-12-1161

Cited by 27 publications

(32 citation statements)

References 42 publications

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“…S3). However, when a meta-analysis was performed using multivariable adjusted effect estimates from 20 studies [5,8,9,18,19,23,25,26,30,31,42,47,49,50,[52][53][54]56,57,64] (n = 52,492), there were no differences among women and men for long-term mortality [RR: 1.01, 95% CI: 0.93-1.11, p = 0.75] (Fig. 4).…”

Section: Resultsmentioning

confidence: 99%

“…Of the 23 studies examining in-hospital events, 7 studies [24,25,31,39,48,53,63] reported rates for in-hospital major bleeding. Pooled analysis show that women had significantly higher in-hospital major bleeding than men [RR: 1.84, 95% CI: 1.40-2.41, p b 0.001] (Supplement Fig.…”

Section: Resultsmentioning

confidence: 99%

“…All of these factors have the potential to impact the decision and ability to administer guideline recommended medical therapies including reperfusion therapy. In general, women are less frequently treated with evidenced based therapies than men [2,31,53,67,68] and women with STEMI are less likely than men to be referred for acute reperfusion [2,16,68]. Our findings of substantial attenuation in mortality risk after adjustment for some of these baseline clinical variables and treatment in a select group of patients treated exclusively with P-PCI lend support to the theory that baseline differences in presentation and treatment contributes to differences in mortality in women and men.…”

Section: Discussionmentioning

confidence: 99%

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Short and long-term mortality in women and men undergoing primary angioplasty: A comprehensive meta-analysis

Bavishi

Bangalore

Patel

et al. 2015

International Journal of Cardiology

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Short and long-term mortality in women and men undergoing primary angioplasty: A comprehensive meta-analysis

Bavishi

Bangalore

Patel

et al. 2015

International Journal of Cardiology

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“…These observations were in line with previous studies comparing women with men in terms of the clinical outcomes after PCI in patients with stable coronary artery disease. 14,27,28 Higher crude cardiac mortality in women, which was no longer significant after adjusting for known confounders, was attributed to those baseline differences. However, women in comparison with men were associated with significantly lower risk for all-cause death, which was mainly driven by the lower risk for noncardiac death.…”

Section: Discussionmentioning

confidence: 95%

Influence of Sex on Long-Term Outcomes After Implantation of Bare-Metal Stent

et al. 2015

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Background-Female sex was reported to be associated with lower risk for midterm restenosis and repeat revascularization after bare-metal stent implantation. However, the influence of sex on very long-term outcomes after bare-metal stent implantation has not been yet reported. Methods and Results-Among the 9877 patients in the multicenter Coronary Revascularization Demonstrating Outcome study in Kyoto (CREDO-Kyoto) registry cohort-1, bare-metal stent implantation was performed in 5313 patients (men, n=3742 and women, n=1571). Follow-up was completed in 4515 patients (85.0%) at 10 years (duration, 10.3±3.1 [0.0-14.1] years). The cumulative incidence of target-lesion revascularization (TLR) was 27% at 1 year and 34% at 10 years (0.8%/y beyond 1 year). Non-target-lesion revascularization (non-TLR) was the dominant coronary revascularization beyond 1 year (13% at 1 year and 31% at 10 years [2.0%/y beyond 1 year]). Cumulative incidence of stent thrombosis was low (1.2% at 1 year and 1.9% at 10 years). Women were older and had greater prevalence of cardiovascular risk factors than men. The cumulative 10-year incidences of and adjusted risk for TLR were significantly higher in men than in women (36% versus 30%, P<0.001; adjusted hazard ratio, 1.29; 95% confidence interval, 1.15-1.46; P<0.001). The higher risk of men relative to women for TLR was consistent regardless of age (<75 years and ≥75 years). Men in comparison with women were also associated with significantly higher adjusted risks for all-cause death, myocardial infarction, stroke, coronary artery bypass grafting, TLR, and non-TLR. Conclusions-TLR and stent thrombosis continued to occur without attenuation up to 10 years after bare-metal stent implantation. Men in comparison with women were associated with higher adjusted 10-year risks for all-cause death, myocardial infarction, stroke, coronary artery bypass grafting, TLR, and non-TLR.

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“…27 A Canadian registry on acute coronary syndrome found that female gender was an independent predictive factor of not receiving ACEI or lipidmodifying agents. 28 In that registry, women were also less frequently treated with BB when compared to men.…”

Section: Discussionmentioning

confidence: 99%

Relationship Between Beta-Blocker and Angiotensin-Converting Enzyme Inhibitor Dose and Clinical Outcome Following Acute Myocardial Infarction

Grall

Bière

Nezet

et al. 2015

Circ J

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Sex-Based Differences in Clinical Practice and Outcomes for Japanese Patients With Acute Myocardial Infarction Undergoing Primary Percutaneous Coronary Intervention

Cited by 27 publications

References 42 publications

Short and long-term mortality in women and men undergoing primary angioplasty: A comprehensive meta-analysis

Short and long-term mortality in women and men undergoing primary angioplasty: A comprehensive meta-analysis

Influence of Sex on Long-Term Outcomes After Implantation of Bare-Metal Stent

Relationship Between Beta-Blocker and Angiotensin-Converting Enzyme Inhibitor Dose and Clinical Outcome Following Acute Myocardial Infarction

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