Sex-Related 30-Day and Long-Term Mortality in Acute Myocardial Infarction Patients Treated with Percutaneous Coronary Intervention

Kanic, Vojko; Vollrath, Maja; Tapajner, Alojz; Sinkovič, Andreja

doi:10.1089/jwh.2016.5957

Cited by 15 publications

(17 citation statements)

References 37 publications

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“…1 ). This gender differences also reflect in 30-day mortality [OR 0.64, 95% CI 0.61–0.66, P = .04, I 2 = 40%; 19 studies (n = 523,304)], [ 2 – 4 , 7 , 8 , 13 – 17 , 23 , 25 , 26 , 33 – 36 , 42 , 53 ] 1-year mortality [OR 0.67, 95% CI 0.60–0.75, P < .001, I 2 = 73%; 20 studies (n = 590,590)] [ 8 , 10 , 13 , 15 – 17 , 20 , 25 , 26 , 28 , 30 , 33 , 35 , 36 , 38 , 43 , 44 , 53 – 55 ] and >2-years mortality [OR 0.71, 95% CI 0.63–0.79, P = .005, I 2 = 57%; 14 studies (n = 43,096)] [ 4 – 6 , 18 , 19 , 23 , 29 , 31 , 34 , 36 , 40 , 43 , 52 , 56 ] (Figs. 2 – 4 ).…”

Section: Resultsmentioning

confidence: 99%

“…[ 2 – 44 ] Some studies have showed persistent gender difference in outcomes after adjusting multivariate factors, [ 2 , 5 , 7 , 9 , 10 , 13 , 15 , 18 , 20 – 25 , 28 , 30 – 33 , 35 – 39 , 41 – 43 ] while other studies also demonstrated that gender was not an independent factor for patient's outcome. [ 3 , 4 , 11 , 12 , 14 , 17 , 19 , 26 , 27 , 29 , 34 , 40 , 44 ] Although previous meta-analysis has demonstrated the effect of gender on response to PCI, which not involved major adverse cardiovascular events (MACE) and revascularization, and the follow-up period was also comparatively short. [ 45 – 48 ] Therefore, this meta-analysis was designed to determine the gender difference in patients with coronary artery disease after PCI, and provide evidence for the development of the guideline.…”

Section: Introductionmentioning

confidence: 99%

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Gender difference in clinical outcomes of the patients with coronary artery disease after percutaneous coronary intervention

et al. 2018

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Section: Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Gender difference in clinical outcomes of the patients with coronary artery disease after percutaneous coronary intervention

et al. 2018

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“…The cause of sex‐specific excess risk is postulated to be multifactorial. Women undergoing PCI have atypical clinical presentation, are frequently delayed in diagnosis and treatment, are older age, and have larger comorbidity burden 1‐9 . However, even after adjustment of these procedural and clinical characteristics, the results are inconsistent among clinical studies 7,10 .…”

Section: Introductionmentioning

confidence: 99%

Sex difference in long‐term clinical outcomes after percutaneous coronary intervention: A propensity‐matched analysis of National Health Insurance data in Republic of Korea

Lee

Choi

Chang

et al. 2021

Cathet Cardio Intervent

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Objective We investigated the gender difference in the 5‐year outcome after percutaneous coronary intervention (PCI) using an unselected population data. Background Sex‐specific outcome after percutaneous coronary intervention (PCI) is not consistent among studies. Methods A total of 48,783 patients were enrolled from a Korean nationwide cohort of PCI in year 2011. Outcomes adjusted with age and propensity for clinical characteristics were compared. Primary outcome was 5‐year cumulative incidence of all‐cause death. Nonfatal major adverse clinical event (MACE) consisting of revascularization, shock, or stroke was also assessed. Results In unadjusted analysis, women were older and had higher frequency of comorbidities including hypertension, hyperlipidemia, and diabetes compared to men (p < .001, all). Women had higher 5‐year death risk than men (21.8 vs. 17.3%; hazard ratio [HR] 1.29, 95% confidential interval [CI] 1.23–1.34). In propensity score‐matched analysis (N = 28,924), women had lower 5‐year death risk (20.2 vs. 26.1%, HR 0.75, 95% CI 0.71–0.78). This lower death risk in women was consistent in subgroup analyses of age, risk factors, and clinical diagnosis including angina or acute myocardial infarction (p < .05, all). Conclusions Older age and more common comorbidities in women contributed to the apparent worse outcome after PCI in women. After adjusting these disadvantages, women had better outcome after PCI than men.

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“…On the other hand, significant differences regarding clinical profile, management and prognosis according to gender have been previously described in patients with cardiovascular disease [ 6 – 9 ]. Importantly a significantly lower adherence to current recommendations has been consistently described in other clinical scenarios, especially in patients with Acute Coronary Syndromes (ACS) [ 10 , 11 ].…”

Section: Introductionmentioning

confidence: 99%

Clinical picture, management and risk stratification in patients with cardiogenic shock: does gender matter?

Collado-Lledó

Llaó

Rivas‐Lasarte

et al. 2020

BMC Cardiovasc Disord

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Background: Early recognition and risk stratification are crucial in cardiogenic shock (CS). A lower adherence to recommendations has been described in women with cardiovascular diseases. Little information exists about disparities in clinical picture, management and performance of risk stratification tools according to gender in patients with CS. Methods: Data from the multicenter Red-Shock registry were used. All consecutive patients with CS were included. Both CardShock and IABP-SHOCK II risk scores were calculated. The primary end-point was in-hospital mortality. The discriminative ability of both scores according to gender was assessed by binary logistic regression, calculating Receiver operating characteristic (ROC) curves and the corresponding area under the curve (AUC). Results: A total of 793 patients were included, of whom 222 (28%) were female. Women were significantly older and had a lower proportion of chronic obstructive pulmonary disease and prior myocardial infarction. CS was less often related to acute coronary syndromes (ACS) in women. The use of vasoactive drugs, renal replacement therapy, invasive ventilation, therapeutic hypothermia and mechanical circulatory support was similar between both groups. In-hospital mortality was 346/793 (43.6%). Mortality was not significantly different according to gender (p = 0.194). Cardshock risk score showed a good ability for predicting in-hospital mortality both in man (AUC 0.69) and women (AUC 0.735). Likewise, the IABP-II successfully predicted in-hospital mortality in both groups (man: AUC 0.693; women: AUC 0.722). Conclusions: No significant differences were observed regarding management and in-hospital mortality according to gender. Both the CardShock and IABP-II risk scores depicted a good ability for predicting mortality also in women with CS.

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Sex-Related 30-Day and Long-Term Mortality in Acute Myocardial Infarction Patients Treated with Percutaneous Coronary Intervention

Abstract: Older age, comorbidities, worse clinical presentation, and adjunctive pharmacotherapy rather than sex may explain the higher mortality rate in women with MI undergoing PCI.

Cited by 15 publications

References 37 publications

Gender difference in clinical outcomes of the patients with coronary artery disease after percutaneous coronary intervention

Gender difference in clinical outcomes of the patients with coronary artery disease after percutaneous coronary intervention

Sex difference in long‐term clinical outcomes after percutaneous coronary intervention: A propensity‐matched analysis of National Health Insurance data in Republic of Korea

Clinical picture, management and risk stratification in patients with cardiogenic shock: does gender matter?

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