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There has been considerable controversy about Percutaneous Coronary Intervetnion (PCI) outcomes between genders with multiple studies reporting either equal or inferior PCI-associated outcomes in women. We sought to describe outcomes and procedure-related complications in females undergoing PCI for Acute Myocardial Infarction (AMI) in an very large all-comer population representative of the US practice.
The study population was derived from the HCUP-NIS for the years 2002-2013. ICD-9 codes were used to identify female patients presenting with AMI who underwent PCI. Propensity score matching was used to adjust for patient and procedural confounders.
Among 3,445,259 patients undergoing PCI for AMI during the study period, 1,117,063 (32.4%) were female. Female patients were older (61.1 vs. 67.0, p<0.0001) with a higher baseline clinical risk, and received drug eluting stents more frequently (57.7% vs 58.1%, p<0.0001). All-cause mortality, procedure related complications rates, length of stay and cost of hospitalization were significantly higher in the female cohort compared to the male group. These statistically significant differences persisted after propensity score matching analysis (Table 1.)
In a large all-comer US dataset, PCI for AMI in female patients remains associated with increased all-cause mortality, length and cost of hospitalization and procedure-related complications compared to male patients. Additional unmeasured confounders likely account for the observed differences.
CORONARY: PCI Outcomes