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Percutaneous coronary intervention in women: in-hospital clinical outcome: experience from a single private institution in Melbourne.
Heart Lung Circ. 2008; 17 Suppl 4:S55-62.HL

Abstract

BACKGROUND

Differences in outcome between women and men treated with percutaneous coronary intervention (PCI) have decreased. This study was aimed at assessing the demographic, clinical, and angiographic features, procedural characteristics and in-hospital results of women undergoing PCI and comparing their results with those of a group of men undergoing PCI throughout the same period of time.

METHODS AND RESULTS

All consecutive PCI procedures performed at Epworth Hospital from November 2004 to January 2007 were analysed. Women and men were compared according to baseline clinical, angiographic and procedural characteristics, angiographic success rates and in-hospital outcomes. A total of 1699 consecutive PCI procedures were performed; of these, 405 PCI (23.8%) were performed in women. Women were older (73.9+/-10 years versus 66.1+/-11.9 years, p<0.0001), had a higher prevalence of hypertension (78% versus 63%, p<0.0001), had lower prevalence of prior myocardial infarction (21% versus 27%, p=0.026), and had less history of prior coronary artery by-pass surgery (13% versus 18%, p=0.023) than men. A greater proportion of women presented with acute coronary syndromes (ACS) to PCI than men (63.7% versus 52.9%, p<0.0001). Women had more complex lesions B2/C (78% versus 74%, p=0.049), a higher proportion of ostial lesions (10.5% versus 5.5%, p<0.0001) and less multivessel disease (48% versus 54% p=0.028) than men. Angiographic lesion success rates were similar in both groups. Total unadjusted in-hospital mortality was higher in women than in men (1.97% versus 0.54%, respectively, p=0.013). This difference in mortality was only at the expense of a higher unadjusted mortality in women presenting with ST segment elevation myocardial infarction (STEMI) than men (17.5% versus 1.87%, p=0.002). No women with a stable coronary syndrome or non-ST-segment elevation acute coronary syndrome (NSTE-ACS) died in hospital. There were no differences in in-hospital myocardial infarction, new revascularisation or stroke between both groups.

CONCLUSIONS

PCI in women has good results but carries an increased unadjusted mortality than in men. This mortality difference between genders in our study, however, was solely at the expense of a higher unadjusted mortality in women than in men undergoing PCI for STEMI.

Authors+Show Affiliations

Victorian Heart Centre, Epworth Hospital Richmond, Victoria, Australia. oquelie@yahoo.com.auNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

18926771

Citation

Oqueli, Ernesto, et al. "Percutaneous Coronary Intervention in Women: In-hospital Clinical Outcome: Experience From a Single Private Institution in Melbourne." Heart, Lung & Circulation, vol. 17 Suppl 4, 2008, pp. S55-62.
Oqueli E, Baker L, Carroll A, et al. Percutaneous coronary intervention in women: in-hospital clinical outcome: experience from a single private institution in Melbourne. Heart Lung Circ. 2008;17 Suppl 4:S55-62.
Oqueli, E., Baker, L., Carroll, A., Hiscock, M., & Dick, R. (2008). Percutaneous coronary intervention in women: in-hospital clinical outcome: experience from a single private institution in Melbourne. Heart, Lung & Circulation, 17 Suppl 4, S55-62. https://doi.org/10.1016/j.hlc.2008.08.002
Oqueli E, et al. Percutaneous Coronary Intervention in Women: In-hospital Clinical Outcome: Experience From a Single Private Institution in Melbourne. Heart Lung Circ. 2008;17 Suppl 4:S55-62. PubMed PMID: 18926771.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Percutaneous coronary intervention in women: in-hospital clinical outcome: experience from a single private institution in Melbourne. AU - Oqueli,Ernesto, AU - Baker,Leonie, AU - Carroll,Aaron, AU - Hiscock,Martin, AU - Dick,Ronald, Y1 - 2008/10/15/ PY - 2008/10/18/pubmed PY - 2009/3/19/medline PY - 2008/10/18/entrez SP - S55 EP - 62 JF - Heart, lung & circulation JO - Heart Lung Circ VL - 17 Suppl 4 N2 - BACKGROUND: Differences in outcome between women and men treated with percutaneous coronary intervention (PCI) have decreased. This study was aimed at assessing the demographic, clinical, and angiographic features, procedural characteristics and in-hospital results of women undergoing PCI and comparing their results with those of a group of men undergoing PCI throughout the same period of time. METHODS AND RESULTS: All consecutive PCI procedures performed at Epworth Hospital from November 2004 to January 2007 were analysed. Women and men were compared according to baseline clinical, angiographic and procedural characteristics, angiographic success rates and in-hospital outcomes. A total of 1699 consecutive PCI procedures were performed; of these, 405 PCI (23.8%) were performed in women. Women were older (73.9+/-10 years versus 66.1+/-11.9 years, p<0.0001), had a higher prevalence of hypertension (78% versus 63%, p<0.0001), had lower prevalence of prior myocardial infarction (21% versus 27%, p=0.026), and had less history of prior coronary artery by-pass surgery (13% versus 18%, p=0.023) than men. A greater proportion of women presented with acute coronary syndromes (ACS) to PCI than men (63.7% versus 52.9%, p<0.0001). Women had more complex lesions B2/C (78% versus 74%, p=0.049), a higher proportion of ostial lesions (10.5% versus 5.5%, p<0.0001) and less multivessel disease (48% versus 54% p=0.028) than men. Angiographic lesion success rates were similar in both groups. Total unadjusted in-hospital mortality was higher in women than in men (1.97% versus 0.54%, respectively, p=0.013). This difference in mortality was only at the expense of a higher unadjusted mortality in women presenting with ST segment elevation myocardial infarction (STEMI) than men (17.5% versus 1.87%, p=0.002). No women with a stable coronary syndrome or non-ST-segment elevation acute coronary syndrome (NSTE-ACS) died in hospital. There were no differences in in-hospital myocardial infarction, new revascularisation or stroke between both groups. CONCLUSIONS: PCI in women has good results but carries an increased unadjusted mortality than in men. This mortality difference between genders in our study, however, was solely at the expense of a higher unadjusted mortality in women than in men undergoing PCI for STEMI. SN - 1444-2892 UR - https://www.unboundmedicine.com/medline/citation/18926771/Percutaneous_coronary_intervention_in_women:_in_hospital_clinical_outcome:_experience_from_a_single_private_institution_in_Melbourne_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1443-9506(08)00850-0 DB - PRIME DP - Unbound Medicine ER -