Abstract 17007: Does Age Modify Gender-based Differences in Clinical Outcomes Following Percutaneous Coronary Intervention (PCI)
Introduction: Women experience higher complication rates and mortality after PCI than men but it remains unknown whether these differences are sustained among younger and older patients.
Hypothesis/Objectives: To investigate if previously reported gender-based disparities in outcome following percutaneous coronary intervention (PCI) are modified by age in a large and racially-diverse cohort in the drug eluting stent (DES) era.
Methods: A total of 23,400 patients (7942 female, 34%) underwent PCI of de novo lesion(s) from 01/2005 to 12/2012 at Mount Sinai Hospital. We compared demographics, procedural characteristics, and 1-year rates of death, myocardial infarction, and major adverse cardiovascular events (MACE), by sex in younger (≤65 years old, n=11,381) and older (>65 years old, n= 12,019) patients.
Results: Regardless of age, compared to males, females had higher body mass index (BMI), better renal function, smoked less, but were more hypertensive and diabetic. Women had higher HDL and LDL cholesterol levels. More women presented with an unstable coronary syndrome and required left anterior descending artery PCI. Women had more vascular and bleeding complications post-PCI but the 30-day readmission rate did not differ between genders within age groups. At 1 year women, in both age categories, were at higher risk for death or myocardial infarction than men. Among younger patients, women had more MACE than men, but formal interaction testing was negative (Figure).
Conclusion: Females undergoing PCI have more comorbidities and are at higher risk for unfavorable outcomes than males. The substantial gender-based differences in clinical outcomes following PCI were independent of age suggesting that preventive strategies should be promoted amongst women.
Author Disclosures: K. Theodoropoulos: None. J. Yu: None. M. Aquino: None. U. Baber: None. S. Roy: None. J. Kovacic: None. J. Sweeny: None. R. Mehran: Research Grant; Modest; The Medicines Company, Bristol-Myers Squibb/Sanofi-Aventis, Lilly/Daiichi Sankyo, Regado Biosciences, Stentys. Consultant/Advisory Board; Modest; Covidien, Janssen Pharmaceuticals, Merck, Sanofi-Aventis, Abbott Vascular, AstraZeneca, Boston Scientific, CLS Behring, Maya Medical. Other; Modest; 25.000 shares for Endothelix Inc. S. Sharma: Speakers Bureau; Modest; BSC, Abbott, Medicine Co., Lilly/Daiichi-Sankyo. A. Kini: None.
- © 2014 by American Heart Association, Inc.