Outcomes by Sex and Ethnicity after Percutaneous Coronary Intervention

Abstract Limited data on sex differences by ethnicity following percutaneous coronary intervention (PCI) exist. In this prospective cohort study, we examined sex differences in 1-year outcomes among patients from 4 ethnic groups who underwent PCI from 2010-2016 at a tertiary center. The primary outcome was 1-year major adverse cardiovascular events (MACE) defined as composite of all-cause death, non-fatal myocardial infarction (MI), or target lesion revascularization (TLR). Secondary outcomes included composite of death or MI and individual components of MACE. Baseline characteristics and outcomes were compared between sex in each ethnic group. The study included 16,361 patients: 7881 whites (26.1% women), 1943 blacks (47.3% women), 2621 Asians (22.6% women), and 3916 Hispanics (39.3% women). Women were older with more comorbidities than men. Unadjusted, women had higher incidence of 1-year MACE than men among whites and Asians but not blacks or Hispanics, which was driven by a greater incidence of death in white women and greater incidence of MI in Asian women compared to male counterparts. After adjustment, findings showed similar risk of 1-year MACE in women versus men in whites, Asians, and Hispanics (Whites: HR 0.95, 95% CI 0.78-1.16; Asians: HR 1.14, 95% CI 0.77-1.67; Hispanics: HR 0.97, 95% CI 0.74-1.27). Black women had lower risk of 1year MACE compared to black men (HR 0.67, 95% CI 0.46-0.97), driven by lower risk of death or MI. In conclusion, this study suggests that risk factors account for adverse events in women after PCI.