Gender Differences Of Clinical Characteristics And Outcomes After Percutaneus Coronary Intervention

Coronary heart disease has high morbidity and mortality, and is one of the most important death causes both in men and women. Lots of studies report that coronary artery disease in women is different from men in terms of its pathogenesy, clinical manifestations, diagnosis and treatments, etc, and there were differences between men and women after percutaneous coronary intervention. This article aimed to exame gender differences of the characteristics and outcomes after coronary artery disease in the real world.PartⅠClinical Characteristics and Outcomes Of Women Patients With ST Segment Elevation Myocardial Infarction Undergoing Percutaneous Coronary InterventionObjective:ST-segment elevation myocardial infarction(STEMI) is one of the leading causes of death in women. It is important to carefully analyze the clinical characteristis and evaluate the in-hospital and long-term outcomes of women patients with STEMI undergoing percutaneous coronary intervention (PCI).Methods:From April 2004 to December 2008, all the women patients with STEMI who underwent PCI in Fuwai hospital were enrolled. There were 118 consecutive women patients and 319 men with STEMI undergoing PCI were selected by cluster random sampling as control group. One year clinical follow-up were done.Results:Baseline clinical characteristics indicated that women group were older (67.80±9.78 vs 57.54±12.95 years old, P＜0.05), had more hypertension and diabetes (52.5%vs 41.1% and 13.6% vs 7.0%, P＜0.05) and less smokers (5.1% vs 55.2%, P＜0.05) than men. Baseline lesion and procedure characteristics indicated that there were more triple vessel disease and bifurcation lesions and lower reference vessel diameter and length of lesion in women group(52.5%vs 41.1%; 13.6% vs 7.0%; 3.02±0.42 mm vs 3.20±1.00mm; and 23.36±10.39 vs 26.29±14.24mm, P＜0.05). One year follow-up results showed that the rate of major adverse cardiac event (MACE), cardiac death and re-acute myocardial infarction were higher in women group (8.3% vs 3.6%,3.2% vs 2%,4.6% vs 1.0%, P＜0.05). Multivariable logistic analysis showed that age (OR:1.116, P＜0.05), hypertension (OR:3.985, P＜0.05), IABP (OR:64.832, P<0.05) and cardiac shock (OR:65.646, P＜0.05) were main independent predictors of in-hospital mortality; age (OR:1.120, P＜0.05) and women (OR:8.055, P＜0.05) were main independent predictors of follow-up mortality.Conclusion:Compared with men, women with STEMI treated with PCI had more clinical risks and worse in-hospital and 1 year outcomes. PartⅡGender differences of clinical characteristics and outcomes among different ages after percutaneus coronary interventionObjective Women undergoing PCI are known to have a higher incidence of adverse outcomes than men. Our aim was to examine the gender differences by comparing the clinical characteristics and outcomes of men and women with coronary artery disease in different ages undergoing PCI.Methods From April 2004 to April 2009, all the women patients after selective PCI in Fuwai hospital were enrolled. There were 1000 women patients and 1685 age-matched men patients after selective PCI were selected by cluster random sampling as control group. All patients were treated according to guidelines. One year clinical follow-up were done in all patients. Clinical datas and outcomes of women patients after selective PCI were compared to age-matched men patients'.Results This study included 1000 women, and 1685 men age-matched patients were selected. The incidences of hypertention and diabetes increased with age, and women had higher percentage than men at the same age. The percentage of type C lesion and CTO lesion increased with age, and men had higher percentage. Left main (LM)than women, left anterior descending (LAD) and burfication lesions were more common in women younger than 45 years compared with men at the same age. The cardiac death increased with age. The in-hospital incidences of major adverse cardiac events, stent thrombosis and in-stent restenosis were similar between men and women at different ages. Women older than 65 years had higher mortality in 1-year followup compared with men at the same age.Conclusion CAD risk factors and the cardiac death were increasing with age. Women and men≤65 years had similar short-term and long-term outcomes after PCI, but for patients＞65 years patients women had higher mortality and MACE than men.