TY - JOUR
T1 - Influence of gender on long-term mortality in patients presenting with NonST-elevation acute coronary syndromes undergoing percutaneous coronary intervention
AU - Kumbhani, Dharam J.
AU - Shishehbor, Mehdi H.
AU - Willis, Joshua M.
AU - Karim, Saima
AU - Singh, Dhssraj
AU - Bavry, Anthony A.
AU - Zishiri, Edwin
AU - Ellis, Stephen G.
AU - Menon, Venu
PY - 2012/4/15
Y1 - 2012/4/15
N2 - 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.
AB - 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.
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U2 - 10.1016/j.amjcard.2011.11.044
DO - 10.1016/j.amjcard.2011.11.044
M3 - Article
C2 - 22245406
AN - SCOPUS:84859270108
SN - 0002-9149
VL - 109
SP - 1087
EP - 1091
JO - American Journal of Cardiology
JF - American Journal of Cardiology
IS - 8
ER -