Abstract 3464: Gender Differences In Coronary Revascularization Rates Following Acute Myocardial Infarction
Objective(s): Studies suggest that early revascularization following an AMI is equally important in both genders. We examined coronary revascularization (PCI or CABG) rates in men and women following an AMI.
Methods: We studied a cohort of 7 728 patients >20 years with an AMI admission between January 1, 1999, and September 30, 2002 who underwent catheterization within 90 days of their index AMI. Demographic, clinical, and procedural data were obtained from the British Columbia (BC) Cardiac Registry, a prospective registry of all cardiac procedures performed in BC. Patients without 180 days of available follow-up and patients with a normal angiogram were excluded. Our primary objective was to examine gender differences in the odds of undergoing coronary revascularization within 180 days of the index coronary catheterization. We also examined time trends in revascularization rates by gender from 1999 to 2002.
Results: Of the 6 726 eligible patients, 68.2% of women and 78.4% of men underwent revascularization within 180 days of their index catheterization following an AMI (p<0.0001). After adjusting for age, extent of vessel disease, hyperlipidemia, LVEF, DM, CHF, CRF, HTN, PVD, CVA, COPD, liver disease, cancer, case complexity, ICU/CCU use, and catheterization year, women were still less likely to undergo revascularization (OR 0.80, 95% CI 0.70 – 0.93). There was no interaction between gender and year of catheterization post-AMI (Figure 1⇓).
Conclusion: Conditional on receiving coronary catheterization within 90 days following an AMI, women were less likely to undergo coronary revascularization within 180 days compared to men. The gender difference persisted from 1999 to 2002.