Sex-based Differences in Percutaneous Coronary Intervention Outcomes in Patients with Ischaemic Heart Disease

Sambola, Antonia; Blanco, Bruno García del; Kunadian, Vijay; Vogel, Birgit; Chieffo, Alaide; Vidal, María Miquel; Ratcovich, Hanna; Botti, Giulia; Wilkinson, Chris; Mehran, Roxana

doi:10.15420/ecr.2022.24

Cited by 11 publications

(5 citation statements)

References 91 publications

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“…In general, women’s heart symptoms are not treated as vigorously as men’s because it is well known that men are more at risk for ischemic heart disease than women. This truism can lead to higher episodes of mortality in women [ 35 ].…”

Section: Resultsmentioning

confidence: 99%

Monitoring the Effectiveness of Treatment in Women with Schizophrenia: New Specialized Cooperative Approaches

Natividad,

Seeman,

Paolini

et al. 2023

Brain Sciences

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Women with schizophrenia have specific health needs that differ from those of men and that change through successive life stages. We aimed to review the biopsychosocial literature on schizophrenia that addresses clinically important questions related to the treatment of women, including somatic morbi-mortality, hyperprolactinemia, comorbid substance use disorders, social risk factors, and medication effectiveness/safety. Data search terms were as follows: (Morbidity AND mortality) OR hyperprolactinemia OR (“substance use disorders” OR addictions) OR (“social risk factors”) OR (“drug safety” OR prescription) AND women AND schizophrenia. A secondary aim was to describe a method of monitoring and interdisciplinary staff strategies. Schizophrenia patients show an increased risk of premature death from cardiovascular/respiratory disease and cancer compared to the general population. The literature suggests that close liaisons with primary care and the introduction of physical exercise groups reduce comorbidity. Various strategies for lowering prolactin levels diminish the negative long-term effects of hyperprolactinemia. Abstinence programs reduce the risk of victimization and trauma in women. Stigma associated with women who have serious psychiatric illness is often linked to reproductive functions. The safety and effectiveness of antipsychotic drug choice and dose differ between men and women and change over a woman’s life cycle. Monitoring needs to be multidisciplinary, knowledgeable, and regular.

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Section: Resultsmentioning

confidence: 99%

Monitoring the Effectiveness of Treatment in Women with Schizophrenia: New Specialized Cooperative Approaches

Natividad,

Seeman,

Paolini

et al. 2023

Brain Sciences

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“…There are several reasons why males may have better outcomes than females after PCI. Males tend to develop CAD at an earlier age, resulting in the presence of fewer comorbidities and risk factors (30)(31)(32). They also generally have larger coronary arteries and less diffuse disease compared to females (30).…”

Section: Discussionmentioning

confidence: 99%

Factors associated with health-related quality of life in patients undergoing percutaneous coronary intervention: Thai PCI registry

Siriyotha,

Pattanaprateep,

Srimahachota

et al. 2023

Front. Cardiovasc. Med.

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BackgroundPercutaneous coronary intervention (PCI) has been shown to improve health-related quality of life (HRQoL) in patients with coronary artery disease (CAD). The objectives of this study were to assess the changes in HRQoL and factors influencing these changes in CAD patients after undergoing PCI.MethodsData from a nationwide PCI registry across 39 hospitals in Thailand were collected in 2018–2019, including baseline characteristics, comorbid diseases, angiographic CAD severity, procedural details, and type of health insurance. HRQoL, as measured by utility scores, was determined in all patients using the Thai version of EQ-5D-5l at admission, discharge, and 6 and 12 months after discharge. The effects of time after PCI procedure and various factors on mean utility scores were assessed using a mixed-effect linear regression model.ResultsA total of 19,701 patients were included in the analysis; they had a mean age of 64.2 ± 11.7 years and were predominantly (69.1%) male. Following PCI, the mean utility scores increased from 66.6 ± 19.6 at admission to 81.9 ± 13.8 at discharge, and remained stable at 6 and 12 months (86.1 ± 12.3 and 88.0 ± 11.7, respectively). After adjusting for potential confounding variables, several factors were found to be independently associated with improved HRQoL, including angiographic success, male gender, overweight status, dyslipidemia, and radial access. Six other factors were associated with less improved HRQoLs, including cardiogenic shock/IABP support, old age, CKD, clinical presentation (STEMI and NSTEMI), prior cerebrovascular disease, and heart failure. There were no associations of CAD severity and procedural details with HRQoL. No differences were found related to type of health insurance, except that patients who were uninsured or self-pay tended to have less improvement in HRQoL.ConclusionHRQoL improved significantly after PCI in these subjects, as observed through 1 year of follow-up. Identifying the factors influencing these improvements may assist clinicians in tailoring patient interventions to optimise quality of life after PCI.

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“…Other factors contributing to longer delays in seeking medical care among female patients, compared with male patients, include lack of knowledge, less aggressive treatment, fear, humiliation, and earlier incorrect diagnoses of chest discomfort by a medical professional [35][36][37]. Second, the higher in-hospital mortality rates among female patients may be partially attributed to their greater burden of comorbidities than that among male patients [38,39]. Consistent with these observations, the current study revealed that female patients were more likely to have comorbidities, including diabetes, renal failure, hypothyroidism, chronic pulmonary disease, valvular disease, and fluid and electrolyte disorders.…”

Section: Sex Differences In In-hospital Outcomes In Patients Who Unde...mentioning

confidence: 99%

Sex disparities in in-hospital outcomes after percutaneous coronary intervention (PCI) in patients with acute myocardial infarction and a history of coronary artery bypass grafting (CABG): A nationwide inpatient sample-matched analysis (2016–2019)

Yan,

Ma,

Shi

et al. 2024

Preprint

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Background The role of sex disparities in in-hospital outcomes after percutaneous coronary intervention (PCI) for acute myocardial infarction (AMI) in patients with a history of coronary artery bypass grafting (CABG) remains underexplored. This study aimed to identify sex disparities in in-hospital outcomes after PCI in patients with AMI and a history of CABG. Methods Using the National Inpatient Sample database, we identified patients hospitalized for AMI with a history of CABG who underwent PCI between 2016 and 2019. The primary outcome was in-hospital mortality, and the secondary outcomes were the length of hospital stay and hospitalization costs. 1:1 propensity score matching was used to minimize standardized mean differences of baseline variables and compare in-hospital outcomes. Results In total, 75,185 weighted hospitalizations of patients who underwent PCI were identified, with 25.2% being female patients. Compared with male patients, female patients exhibited elevated risks of in-hospital mortality (3.72% vs. 2.85%, p = 0.0095), longer length of stay (4.64 days vs. 3.96 days, p < 0.001), and higher hospitalization costs ($112,594.43 vs. $107,020.54, p = 0.0019). After propensity score matching, female patients had higher in-hospital mortality rates than male patients (3.81% vs. 2.89%, p = 0.028). Multivariable logistic regression (adjusted odds ratio [aOR]: 1.48; 95% confidence interval [CI]: 1.14–1.92) and propensity score matching (aOR: 1.34; 95% CI: 1.03–1.73) showed a consistently higher risk of in-hospital mortality among female patients than among male patients. Female patients aged >60 years were more vulnerable to in-hospital mortality than were their male counterparts (3.06% vs. 4.15%, p = 0.0003, aOR: 1.55; 95% CI: 1.18–2.04). Conclusions Female patients who underwent PCI for AMI with a history of CABG had a higher in-hospital mortality rate, which was particularly evident among older patients aged >60 years. Therefore, sex- and age-specific investigations and interventions are required to reduce disparities within this high-risk population.

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Sex-based Differences in Percutaneous Coronary Intervention Outcomes in Patients with Ischaemic Heart Disease

Cited by 11 publications

References 91 publications

Monitoring the Effectiveness of Treatment in Women with Schizophrenia: New Specialized Cooperative Approaches

Monitoring the Effectiveness of Treatment in Women with Schizophrenia: New Specialized Cooperative Approaches

Factors associated with health-related quality of life in patients undergoing percutaneous coronary intervention: Thai PCI registry

Sex disparities in in-hospital outcomes after percutaneous coronary intervention (PCI) in patients with acute myocardial infarction and a history of coronary artery bypass grafting (CABG): A nationwide inpatient sample-matched analysis (2016–2019)

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