Comparison of long-term outcomes between men and women after percutaneous coronary intervention

Background Differences between long-term outcomes among women and men treated by percutaneous intervention (PCI) are unknown. Purpose To compare characteristics mortality and impact of gender on poor outcomes after PCI. Methods Consecutive men and women admitted for PCI between 2008 and 2011 were prospectively included and followed-up until January 2019. Major adverse cardiovascular and cerebrovascular events (MACCE) and causes of death were collected through consultations, calls and death certificates. The primary endpoint was all-cause mortality according to gender. Secondary endpoints were cardiovascular death, non-cardiovascular death and MACCEs. Results A total of 3524 patients including 2720 men (77.1%) and 804 women (22.8%) were followed-up for a median time of 7.0 years (IQ1: 5.4; IQ 3: 7.2) with a follow rate of 97.6%. At baseline, women were older (70 ± 13.1 vs. 64.6 ± 12 years old) and smoked less (18.9% vs. 30.4%), had more frequently hypertension (67.9% vs. 58.1%) and chronic kidney disease (42.6% vs. 22.7%), whereas diabetes rate was similar around 29%. PCI for myocardial infarction at admission represented 23% with no difference according to gender. Prognosis was severe as all-cause death occurred for 30.3% and MACCE for 40.9% of all patients. In unadjusted analyses, women had a higher risk of all-cause mortality (35% vs. 29%, HR = 1.25, 95%CI [1.09–1.43], P = 0.0015) and cardiovascular mortality (61% vs. 57%, HR = 1.31, 95%CI [1.10–1.56]) but there was no difference on occurrence of MACCE (HR = 1.079, 95%CI [0.9271–1.221]). After adjustment for baseline cardiovascular risk factors, presentation and severity of coronary disease, there was no difference between men and women for mortality ( Fig. 1 ). Conclusions In this long-term follow-up, women had a higher risk of all-cause and cardiovascular mortality after PCI in unadjusted analyses. However, gender was not independently associated with mortality after adjustment for cardiovascular risk factors.