Abstract
BackgroundData was limited on the rates of in-hospital and 30-days composite outcomes between male and female patients with coronary heart disease (CHD) undergoing percutaneous coronary intervention (PCI).MethodsThis was a retrospective study and CHD patients undergoing PCI between January and December of 2018 were screened and recruited. Baseline characteristics, in-hospital and 30-days composite outcomes were compared by gender. The factors influencing gender-outcome associations were evaluated.ResultsA total of 672 CHD patients undergoing PCI were included into current analysis. Compared to males, females were older (53.8 ± 12.7 years vs 50.6 ± 11.8 years), more likely to be obese (32.9% vs 29.4%) and had higher prevalence of hypertension (46.7% vs 41%). Females were less likely to be smoker (30.3% vs 1.1%), have prior history of CHD (4.4% vs 10.9%), and lower socioeconomic status [SES; full-time employment (64.4% vs 71.9%), education attainment ≥ college (29.6% vs 36.8%) and annual income ≥60,000 RMB (23.7% vs 27.1%)]. Hospitalized stay was longer in females (median 5.2 vs 4.0 days), and females were more likely to experience in-hospital bleeding (3.0% vs 1.2%) and 30-days non-fatal myocardial infarction (5.9% vs 2.9%). In unadjusted model, compared to males, females had a crude odds ratio (OR) of 2.05 (95% confidence interval [CI] 1.68–2.59) for in-hospital composite outcomes and 2.16 (95% CI 1.74–2.63) for 30-days post-PCI composite outcomes. After adjustment for potential covariates, female gender remains independently associated with in-hospital and 30-days post-PCI composite outcomes. OR change was the greatest with adjustment for SES when compared to other covariates.ConclusionCompared to male patients, female patients had a higher risk of in-hospital and 30-days composite outcomes post-PCI treatment, which were mainly attributed to the differences in SES.
Highlights
Data was limited on the rates of in-hospital and 30-days composite outcomes between male and female patients with coronary heart disease (CHD) undergoing percutaneous coronary intervention (PCI)
Baseline characteristics comparison by gender Female patients accounted for 40.2% (n = 270) of current analysis
One systemic review shows that compared to males with ST-segment elevation myocardial infarction (STEMI), females with STEMI had higher mortality rate and this difference was partially attributed to the differences in baseline cardiovascular risk profiles [16]
Summary
Data was limited on the rates of in-hospital and 30-days composite outcomes between male and female patients with coronary heart disease (CHD) undergoing percutaneous coronary intervention (PCI). China Cardiovascular Disease Report shows that the number of CHD patients undergoing PCI was increased annually in China, and compared to male patients, female patients were less likely to receive primary PCI with an ACS presentation [11,12,13]. Prior studies from developed countries have shown that female patients undergoing PCI had more procedure-related complications and poorer outcomes than their male counterparts, data on the gender-specific outcomes in Chinese CHD patients undergoing PCI were limited. With aging and endemic of cardiovascular risk factors, the prevalence and incidence of CHD among postmenopausal females were approaching to or even surpassing that of male patients [5, 14, 15]. Elucidating gender-specific outcomes among CHD patients undergoing PCI is clinically important in China
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