Abstract 18915: Bleeding and Vascular Complications Following PCI in Women No Longer Exceed Those of Men: A Single Center Comparison of Then (2008) versus Now (2015)
Introduction: Historically, women have had higher vascular complications compared to men when undergoing a percutaneous coronary intervention (PCI). While increasing transradial access reduces bleeding complications, other contemporaneous changes such as a reduction in GP IIbIIIa inhibitor use and novel antithrombotic approaches also contribute. Few real-world studies have been done to assess the effects of bleeding reduction techniques on the gap between men and women in PCI-related bleeding complications.
Hypothesis: Transradial access and other bleeding-avoidance approaches for PCI have narrowed the gender gap between men and women in vascular and bleeding complications.
Methods: We queried the Dartmouth Dynamic Registry for all PCI’s performed at a time when radial access was rare and IIbIIIa use was more routine (2008) and a more recent time when radial access was more common and IIbIIIa use was rare (2015). Baseline demographics, procedural characteristics, and outcomes were collected for both time periods for women and men. We compared in-hospital bleeding (large hematoma and/or need for transfusion) and vascular complications (pseudoaneurysm, RP bleed, AV fistula) between men and women. Statistical significance was determined using the Fischer’s exact test.
Results: We identified 1256 PCI’s in 2008, of which 365 (29%) were women, and 946 PCI’s in 2015, of which 272 (29%) were women. Radial artery access in 2008 was rare (1-2%), increasing over ten fold in 2015 (15-17%). When compared with 2008, the overall bleeding rate fell for women in 2015 (Table 1). The statistically higher rates of bleeding seen in 2008 for women compared to men were no longer present in 2015. Vascular injury rates fell in both men and women between 2008 and 2015.
Conclusions: Bleeding rates and vascular complication rates have fallen between the years 2008 and 2015. The statistically higher rates of bleeding following PCI in women compared to men seen in 2008 no longer exist in 2015.
Author Disclosures: H.I. Chaudry: None. S.X. Li: None. T.B. Curran: None. N.I. Buss: None. B.W. Andrus: None. S.M. Conley: None. J.T. DeVries: None.
- © 2016 by American Heart Association, Inc.