Author + information
- Katherine Yu,
- Ashwini Erande,
- Megha Agarwal,
- Melvie Kim,
- Pranav Patel,
- Alpesh Amin and
- Shaista Malik
Background: Previous data from single or regional medical centers suggest women higher rates of vascular complications (VC) and mortality than men following percutaneous coronary intervention (PCI) during hospitalization for an acute myocardial infarction (AMI). We assessed the rate of VC and mortality among women compared to men, following PCI in a contemporary, large sample of patients admitted for AMI.
Methods and Results: Using data from the Nationwide Inpatient Sample registry of persons hospitalized with AMI in the USA who underwent PCI from 2001-2011 n=2,812,062), we performed multivariate logistic regression to assess the relationship of sex and post-PCI VC as well as in-hospital mortality; adjusting for demographics, comorbidities, and hospital factors. In models stratified by sex, we evaluated the association of comorbidities with VC and subsequent mortality. The crude rate for VC complication following PCI was 7.3% for women and 4.2% for men. After adjusting for age, ethnicity, income, length of stay, hospital characteristics, and patient comorbidities, women were more likely to have a VC (OR=1.64; 95% CI 1.63-1.66) as well as more likely to experience in-hospital death (OR=1.14; 95% CI 1.08-1.19) compared to men. Examining annual rates over the time period of our study, women continued to have more VC compared to men (OR 1.51- 1.83), despite the advances in cardiac catheterization techniques. There were no trends toward improvement in gender disparities. Comorbidities predictive of women who experienced VC and mortality included peripheral vascular disease and atrial fibrillation.
Conclusions: Female gender is a significant independent risk factor for VC and mortality post-PCI in AMI. Despite new techniques in cardiac catheterization to minimize bleeding complications, the overall trend in the past 10 years continues to show that women have more VC post-angiogram regardless of age. To close the gender gap in VC and mortality, future studies are needed to understand the etiology of these differences in outcomes.
Poster Hall, Hall C
Sunday, March 19, 2017, 9:45 a.m.-10:30 a.m.
Session Title: Interventional Complexity and Complications
Abstract Category: 26. Interventional Cardiology: Vascular Access and Complications
Presentation Number: 1285-171
- 2017 American College of Cardiology Foundation