Gender differences in in-hospital clinical outcomes after percutaneous coronary interventions: an insight from a Japanese multicenter registry.

Autor:	Numasawa Y; Department of Cardiology, Ashikaga Red Cross Hospital, Tochigi, Japan., Kohsaka S; Department of Cardiology, Keio University School of Medicine, Tokyo, Japan., Miyata H; The University of Tokyo, Healthcare Quality Assessment, Tokyo, Japan., Noma S; Department of Cardiology, Saiseikai Utsunomiya Hospital, Tochigi, Japan., Suzuki M; Department of Cardiology, National Hospital Organization, Saitama National Hospital, Saitama, Japan., Ishikawa S; Department of Cardiology, Saitama City Hospital, Saitama, Japan., Nakamura I; Department of Cardiology, Hino Municipal Hospital, Tokyo, Japan., Nishi Y; Department of Cardiology, St Luke's International Hospital Heart Center, Tokyo, Japan., Ohki T; Department of Cardiology, Tokyo Dental College Ichikawa General Hospital, Chiba, Japan., Negishi K; Department of Cardiology, Yokohama Municipal Hospital, Kanagawa, Japan., Takahashi T; Department of Cardiology, Ashikaga Red Cross Hospital, Tochigi, Japan., Fukuda K; Department of Cardiology, Keio University School of Medicine, Tokyo, Japan.
Jazyk:	angličtina
Zdroj:	PloS one [PLoS One] 2015 Jan 30; Vol. 10 (1), pp. e0116496. Date of Electronic Publication: 2015 Jan 30 (Print Publication: 2015).
DOI:	10.1371/journal.pone.0116496
Abstrakt:	Background: Gender differences in clinical outcomes after percutaneous coronary intervention (PCI) among different age groups are controversial in the era of drug-eluting stents, especially among the Asian population who are at higher risk for bleeding complications. Methods and Results: We analyzed data from 10,220 patients who underwent PCI procedures performed at 14 Japanese hospitals from September 2008 to April 2013. A total of 2,106 (20.6%) patients were women. Women were older (72.7±9.7 vs 66.6±10.8 years, p<0.001), and had a lower body mass index (23.4±4.0 vs 24.3±3.5, p<0.001), with a higher prevalence of hypertension (p<0.001), hyperlipidemia (p<0.001), insulin-dependent diabetes (p<0.001), renal failure (p<0.001), and heart failure (p<0.001) compared with men. Men tended to have more bifurcation lesions (p = 0.003) and chronic totally occluded lesions (p<0.001) than women. Crude overall complications (14.8% vs 9.5%, p<0.001) and the rate of bleeding complications (5.3% vs 2.8%, p<0.001) were significantly higher in women than in men. On multivariate analysis in the total cohort, female sex was an independent predictor of overall complications (OR, 1.47; 95% CI, 1.26-1.71; p<0.001) and bleeding complications (OR, 1.74; 95% CI, 1.36-2.24; p<0.001) after adjustment for confounding variables. A similar trend was observed across the middle-aged group (≥55 and <75 years) and old age group (≥75 years). Conclusions: Women are at higher risk than men for post-procedural complications after PCI, regardless of age.
Databáze:	MEDLINE
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