Influence of Age and Gender on Clinical Outcomes Following Percutaneous Coronary Intervention for Acute Coronary Syndromes

Abstract

Gender and age are non-modifiable factors influencing clinical outcomes in acute coronary syndromes (ACS). We evaluated the effect of age and gender on clinical outcomes in patients with ACS undergoing percutaneous coronary interventions (PCI). Methods and results: We evaluated clinical outcomes (mortality, target vessel revascularisation (TVR), stent thrombosis (ST) and myocardial infarction (MI)) in 3094 (75.6% males) consecutive ACS patients (2003–2010) who underwent PCI at Liverpool Hospital. Patients were divided into two age groups (Group 1 <65 years = 1840, Group 2 ≥65 years = 1254). Females were more likely to have diabetes (30% vs. 22%, p < 0.001) and hypertension (63% vs. 49%, p < 0.001), and less likely to be smokers (19% vs. 30%, p < 0.001). 60% of female were elderly compared with 43% among males (p < 0.001). Females were less likely to have class B2/C lesions (63% vs. 67%, p = 0.045) and more likely to have smaller stent diameter (2.75 [2.5–3] mm vs. 3 [2.75–3] mm, p < 0.001). DES use was similar in males and females (p = 0.430). At 27 (IQR: 17–49) months, all cause mortality was higher among females compared with male (15% vs. 10%, p < 0.001) with no differences in other clinical outcomes. In Group 1, mortality was higher in females (8.8% vs. 4.5%, p = 0.004), with no significant difference in ST, MI and TVR rates. In Group 2, TVR rates were less in females (7.5% vs. 11.6%, p = 0.023), while other clinical outcomes similar. Conclusion: Females had less complex coronary lesions but involving smaller vessels. Mortality is higher in younger female underwent PCI for, and may be due to higher incidence of diabetes and hypertension.