Sex Differences in Characteristics, Treatments, and In-hospital Outcomes of Patients Undergoing Coronary Angiography or Intervention

Abstract

BackgroundWhether women have a higher risk of adverse events compared with men following coronary angiography (CAG) and percutaneous coronary intervention (PCI) remains controversial. We aimed to investigate the sex differences in characteristics, treatments and outcomes among patients undergoing CAG and PCI in a large Chinese cohort.MethodsWe analyzed patients undergoing CAG and/or PCI in this multi-center registry cohort study Cardiorenal ImprovemeNt II (CIN-II) in 5 Chinese tertiary hospitals from 2007 to 2020. Clinical characteristics, treatment (discharge medication and PCI) and in-hospital outcomes (mortality and major bleeding) were compared between women and men.ResultsTotally 141,459 patients underwent CAG (44,362 [31.4%] women), of which 69,345 patients underwent PCI (15,376 [22.2%] women). Women were older (64.4 vs. 60.8 years), had more chronic comorbidities and lower PCI rate for stable coronary artery disease (CAD) than men (52.8 vs. 64.2%). Women received less CAG and PCI procedures. Among women undergoing PCI they received similar discharge medication treatment. In addition, women undergoing PCI had mildly lower rate of major bleeding (0.2 vs. 0.3%, P = 0.033) but higher in-hospital mortality (1.2 vs. 0.8%, P < 0.001). After adjustment, women had a higher risk in the major bleeding (adjusted odds ratio, 2.04 [95% CI: 1.07 to 3.62]), and the in-hospital mortality (adjusted odds ratio, 1.87 [95% CI: 1.36 to 2.56]).ConclusionAmong our Chinese cohort, women are older with more chronic comorbidities, receiving less PCI procedure and similar discharge medication treatment. Women have nearly 90% higher risk of in-hospital mortality and over 1-fold increased risk of major bleeding after PCI compared with men.

Predictive effect of estimated glomerular filtrate rate by creatinine or cystatin C on mortality in patients with coronary artery disease

“…This retrospective and multi-center study included patients from the registry cohort of Cardiorenal ImprovemeNt II (CIN-II, NCT05050877) during 2007 to 2020 in five south Chinese tertiary teaching hospitals, which covered 145,267 subjects undergoing coronary catheterization [ 10 ]. Patients meeting the following criteria were included: 1) age ≥18 years; 2) with CAD; 3) hospitalized for the first time.…”

Effect of Urinary Albumin Creatinine Ratio on Cardiovascular Morbidity and Mortality in Diabetes Patients with Atherosclerotic Disease

“…Considering the time consistency among different centers, we included the patients from 2007 to 2020. 13 Patients not hospitalised for the first time were excluded, as well as patients without discharge status reporting. Patients without records of uACR were excluded.…”

Proportion and number of incident cancer deaths in coronary artery disease

“…This multi‐center, retrospective study was based on the coronary angiography (CAG) among Cardiorenal ImprovemeNt II cohort (CIN‐II, NCT05050877) among five regional central tertiary teaching hospitals in China 15 . All consecutive CAD patients (≥18 years) firstly admitted for CAG were included from 2007 to 2020.…”

“…CAD was confirmed by coronary angiography, and the main artery stenosis was more than 30%; one of the other three coronary vessels stenosis was more than 50%. 15 Chronic kidney disease was defined as an estimated glomerular filtration rate ≤ 60 mL/min/1.73 m 2 using Chronic Kidney Diseases Epidemiology Collaboration equation. 18 Anemia was defined as hematocrit <36% for female and <39% for male.…”

“…The details of data governance have been introduced in the previous study. 15 To identify the survival information of patients with CAD, we also linked cause-specific surveillance dataset at the regional Center for Disease Control and Prevention. Senior cardiologists were responsible for the data quality control and periodically carried out database checking.…”