Sex Differences in Percutaneous Coronary Intervention-Insights From the Coronary Angiography and PCI Registry of the German Society of Cardiology

Background--several studies have suggested sex-related differences in diagnostic and invasive therapeutic coronary procedures. methods and results--data from consecutive patients who were enrolled in the coronary angiography and pci registry of the german society of cardiology were analyzed. we aimed to compare sex-related differences in in-hospital outcomes of patients undergoing percutaneous coronary intervention (pci) for stable coronary artery disease,non-st elevation acute coronary syndromes,st elevation myocardial infarction,and cardiogenic shock. from 2007 until the end of 2009 data from 185 312 pcis were prospectively registered: 27.9% of the pcis were performed in women. primary pci success rate was identical between the sexes (94%). there were no sex-related differences in hospital mortality among patients undergoing pci for stable coronary artery disease,non-st elevation acute coronary syndromes,or cardiogenic shock except among st elevation myocardial infarction patients. compared to men,women undergoing primary pci for st elevation myocardial infarction have a higher risk of in-hospital death,age-adjusted odds ratio (1.19,95% ci 1.06-1.33),and risk of ischemic cardiac and cerebrovascular events (death,myocardial infarction,transient ischemic attack/stroke),(age-adjusted odds ratio 1.19,95% ci 1.16-1.29). furthermore,accessrelated complications were twice as high in women,irrespective of the indication. conclusions--despite identical technical success rates of pci between the 2 sexes,women with pci for st elevation myocardial infarction have a 20% higher age-adjusted risk of death and of ischemic cardiac and cerebrovascular events. further research is needed to determine the reasons for these differences. © 2017 the authors.