Influence of gender on long-term mortality in patients presenting with NonST-elevation acute coronary syndromes undergoing percutaneous coronary intervention

Dharam J. Kumbhani, Mehdi H. Shishehbor, Joshua M. Willis, Saima Karim, Dhssraj Singh, Anthony A. Bavry, Edwin Zishiri, Stephen G. Ellis, Venu Menon

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Abstract

Although an invasive strategy has predominately been studied in men with nonST-segment elevation acute coronary syndromes (NSTE-ACSs), its role in low-risk women is unclear. We sought to examine gender differences in a real-world registry of patients with NSTE-ACS who underwent percutaneous coronary intervention (PCI). Patients with NSTE-ACS undergoing PCI at the Cleveland Clinic, Cleveland, Ohio from 2003 through 2007 (n = 1,874) were included. In-hospital and long-term mortalities were assessed. Cox proportional hazards models were constructed to study the influence of gender on mortality. Interactions with age and biomarker status were examined. Women were older and had a higher incidence of co-morbid conditions compared to men. They had a smaller reference vessel diameter compared to men. Despite these characteristics there was no overall difference in in-hospital (1.4% vs 1.6%) or long-term (14.6% vs 15.8%) mortality between men and women. However, there was evidence of a significant effect modification by age (p = 0.012) and troponin status (p = 0.0073) for long-term mortality such that women <60 years of age, especially those who were troponin negative, had more than a twofold increase in long-term mortality compared to men (p = 0.007). In conclusion, although overall mortality rates are similar between men and women undergoing PCI for NSTE-ACS, women <60 years old with negative biomarkers have a higher mortality than their men peers.

Original languageEnglish (US)
Pages (from-to)1087-1091
Number of pages5
JournalAmerican Journal of Cardiology
Volume109
Issue number8
DOIs
StatePublished - Apr 15 2012

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Percutaneous Coronary Intervention
Acute Coronary Syndrome
Mortality
Troponin
Biomarkers
Proportional Hazards Models
Registries
Incidence

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Influence of gender on long-term mortality in patients presenting with NonST-elevation acute coronary syndromes undergoing percutaneous coronary intervention. / Kumbhani, Dharam J.; Shishehbor, Mehdi H.; Willis, Joshua M.; Karim, Saima; Singh, Dhssraj; Bavry, Anthony A.; Zishiri, Edwin; Ellis, Stephen G.; Menon, Venu.

In: American Journal of Cardiology, Vol. 109, No. 8, 15.04.2012, p. 1087-1091.

Research output: Contribution to journalArticle

Kumbhani, Dharam J. ; Shishehbor, Mehdi H. ; Willis, Joshua M. ; Karim, Saima ; Singh, Dhssraj ; Bavry, Anthony A. ; Zishiri, Edwin ; Ellis, Stephen G. ; Menon, Venu. / Influence of gender on long-term mortality in patients presenting with NonST-elevation acute coronary syndromes undergoing percutaneous coronary intervention. In: American Journal of Cardiology. 2012 ; Vol. 109, No. 8. pp. 1087-1091.
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