Abstract 11826: Association of Bleeding, Mortality and Gender in Acute Coronary Syndromes: The “Gender Triangle” . A Gender-based Prospective Observational Study From Real Registry
Background: Percutaneous coronary intervention (PCI) and antithrombotic drugs is the standard therapy in patients with acute coronary syndromes (ACS), but the impact on bleeding and mortality has not been adequately investigated in women presenting with ACS.
Methods: We conducted a prospective observational cohort study on ACS patients referred for coronary angiography (CA) and PCI in Emilia-Romagna between June 2010 and November 2011 in 6 out of 13 centres part of REAL program. Primary objective was to test whether in-hospital bleeding (according to GRACE and TIMI definition) is significantly higher in females compared to males and to evaluate it's impact on short and long-tem mortality.
Results: At this time, data are available in 1828 patients who underwent 2106 procedures. Results are shown in tables and figures below. Women were older (73±12 vs 68±12, p< 0,0001), but did not show a worse risk profile in comparison with men; anticoagulant and anti-platelet treatment was significantly under utilized in women, as was the use of the radial approach. Women had significantly higher rate of in-hospital major bleeding (3% vs 1,6%; p 0,047), higher incidence of both short-term and long-term total mortality compared to men (11.7 vs 7.7%, logrank 0.006). Female gender was identified as the only independent predictor of in-hospital bleeding (OR 1.6, 1.07-2.41 95%CI). However, bleeding but not female gender, was identified as predictor of 30 days mortality.
Conclusion: In a contemporary PCI registry in Italy, women exhibit worse bleeding and mortality outcomes compared to men. These data strongly support the important link between the triad of female gender, bleeding and mortality
- © 2012 by American Heart Association, Inc.