P5490Sex-related differences in intrahospital outcome of patients undergoing PCI

Abstract

Background Cardiovascular diseases remain the number one cause of mortality in the world despite modern scientific and therapeutic advancement. Gender difference pathophysiology, treatment and outcome have been hypothesized and studied. Whether there are sex differences in the outcome after PCI remains controversial. Aim of the study We undertook this study to assess whether there are sex-related differences in intrahospital outcome of patients undergoing percutaneous coronary intervention. Materials and methods This is a prospective observational study. We enrolled consecutively all patients undergoing PCI in UHC “Mother Theresa” from April to October 2018 and were followed in the 1st Clinic of Cardiology. Data for 352 patients were collected, 261 males and 91 females. We excluded from the study patients that could not be followed. Results Women were older (5.27; 95% CI: 2.98–7.6; p<0.001), had more hypertension (p≤0.001), Diabetes Mellitus (p≤0.001), while men were more likely to be smokers (p≤0.001). Female sex had a higher unadjusted mortality rate (5.5% vs. 1.5%, p=0.039) which vanished after adjustments for age, co-morbidities and procedural or infarct related complications (p=0.237). The age-group with the highest mortality rate was that of 61–70 years. Women had more procedure related complications like inguinal hematomas (p=0.02), pseudo aneurisms (p=0.005) and contrast induced nephropathy (p=0.021). Female gender was associated with more severe peri-procedural arrhythmias in the setting of AMI (p=0.039). Total hospital stay was longer for women (p=0.001), after elective PCI (p=0.01) and after primary PCI (p=0.007). After multivariate analysis and adjustment, female gender remained an independent factor for prolonged hospitalization. Conclusion Female sex seems to have a tendency for higher mortality even after losing its significance after multivariate adjustments. Females get more myocardial infarction and procedural related complications and have longer hospital stays than men.

Gender Differences in Admissions and In-Hospital Outcomes of Patients With Acute Coronary Syndromes During the Coronavirus Disease 2019 Pandemic

“…In our study, during the “normal” 2019 year, compared to males, females subjected to the so-called gender paradox of coronary disease tended to present later (424.72 ± 352.6 versus 467.46 ± 457.63), had worse outcomes, had higher mortality (6.0% versus 2.5%; p = 0.01), but tended to have smaller coronary disease extent (more than one-vessel CAD, less than two and three-vessel CAD) and better ejection fraction (50.68 ± 11.33 vs. 51.65 ± 12.40) (Table 5 ). The paradox of coronary disease is described in other studies conducted worldwide [ 24 ] and previously in Albania [ 25 ].…”