Abstract 15682: Does Gender Still Influence Mortality Post Percutaneous Coronary Intervention (PCI)? A Meta-Analysis of the Impact of Gender on PCI Outcomes
Objectives: We examined the effect of gender on mortality and morbidity post PCI.
Background: Female gender traditionally has been associated with worse overall outcomes post PCI. It is hypothesized that women with CAD tend to be older and have more co-morbid conditions. It is thought that those factors may increase the risk of complications and cardiovascular mortality. However, there is no conclusive evidence whether women have higher mortality and rate of complications in recent times.
Methods: An extensive literature search using PubMed (MeSH keywords: ‘PCI’ & ‘gender’) identified 31 studies reporting PCI outcomes with gender stratification. We limited our search from 01/01/2000 - 01/31/2014. Thirty one studies were chosen and a total of 707,448 patients (463,053 men, 244,395 women) were included in this analysis. Data on baseline and clinical outcomes were extracted. Clinical outcomes of interest included all-cause mortality, non-fatal MI, stroke and repeat revascularization. Effect size was estimated using Odds Ratio with 95% confidence intervals. Given inherent heterogeneity in reported data, random effects model was used.
Results: Women tended to have higher mortality than men post PCI:in-hospital mortality 2.7% vs 1.4%, OR 1.69(1.46-1.96), 30-day mortality 18.7% vs 12.2%, OR 1.78(1.46-2.16) and 1 year mortality 13% vs 8.36%, OR 1.49(1.31-1.69). There was no difference in rates of non-fatal MI between men and women [in-hospital MI 1.6% vs 1.4%, OR 1.1(0.92-1.32); 30-day MI 1.94% vs 1.91%, OR 1.02(0.87-1.21) and 1-year MI 10.8% vs 9.64% OR 1.11(0.99-1.25)]. Women also had higher rates of stroke while in-hospital, 0.28% vs. 0.15% OR 1.82(1.22-2.70). The two groups had comparable rates of PCI and CABG at follow-up.
Conclusions: Women tend to have higher mortality post-PCI at both short and intermediate term follow-up. There is comparable rate of non-fatal MI and repeat revascularization post PCI.
Author Disclosures: A. Ahmed: None. D. Pham: None. S. Virani: None. I.R. Hamzeh: None. H. Jneid: None. N. Lakkis: None. M. Alam: None.
- © 2014 by American Heart Association, Inc.