Gender Difference In Clinical Outcomes Of The Patients With Coronary Artery Disease After Percutaneous Coronary Intervention:A Systematic Review And Meta-analysis

Background and objective: Previous researches have reported the controversial results regarding the gender difference in clinical outcomes of patients with coronary artery disease(CAD)after percutaneous coronary intervention(PCI).Hence,this systematic review and meta-analysis was designed to investigate whether gender difference existed in clinical outcomes of the patients after PCI.Methods: PubMed,Cochrane Library,Embase,China National Knowledge Infrastructure(CNKI),Wan Fang and Sino Med were searched up to February-10-2018.Studies comparing the gender-specific effect on clinical outcomes of patients with coronary artery disease after percutaneous coronary intervention were identified,to analyze mortality,major adverse cardiovascular events(MACE)and revascularization.Statistical software Rev Man was utilized in this meta-analysis.Results: A total of 55 studies involving 1,051,095 patients(786,627 male and264,468 female)reported sex-specific outcomes were included in this study.The in-hospital mortality,30-day mortality,1-year mortality and at least 2-years mortality in male patients with coronary artery disease after percutaneous coronary intervention were significantly lower than those of females(odds ratio [OR] 0.57,95% confidence interval [CI] 0.51-0.63,P<0.001;OR 0.63,95% CI 0.61-0.66,P=0.006;OR 0.67,95% CI 0.60-0.74,P<0.001 and OR 0.72,95% CI 0.64-0.81,P=0.0001,respectively).The MACE was significantly decreased in male subjects after initial percutaneous coronary intervention compared with females in less than 1-year or at least 1-year(OR 0.67,95% CI 0.57-0.79,P<0.001;OR 0.87,95% CI 0.79-0.97,P<0.001).The male patients after percutaneous coronary intervention harbored higher rate of revascularization compared with females for at least 1-year(OR 1.16,95% CI1.02-1.32,P<0.001),while the rate of revascularization in male patients for less than1-year was lower than that of females(OR 0.94,95% CI 0.72-1.22,P=0.01).Conclusions: The systematic review and meta-analysis suggests that the prognosis of male patients with coronary artery disease after percutaneous coronary intervention is better than that of females,except for long-term revascularization.