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CLINICAL RESEARCH: INTERVENTIONAL CARDIOLOGY

Mortality Differences Between Men and Women After Percutaneous Coronary Interventions

A 25-Year, Single-Center Experience

Mandeep Singh, MD^_*,_*, Charanjit S. Rihal, MD^_*, Bernard J. Gersh, MB, ChB, DPhil^_*, Veronique L. Roger, MD^_*, Malcolm R. Bell, MD^_*, Ryan J. Lennon, MS, Amir Lerman, MD^_* and David R. Holmes, Jr, MD^_*

^_* Division of Cardiovascular Diseases, Mayo Clinic, Rochester, Minnesota
Division of Biostatistics, Mayo Clinic, Rochester, Minnesota.

Manuscript received July 6, 2007; revised manuscript received January 2, 2008, accepted January 14, 2008.

^_* Reprint requests and correspondence: Dr. Mandeep Singh, Division of Cardiovascular Diseases, Mayo Clinic, 200 First Street SW, Rochester, Minnesota 55905. (Email: singh.mandeep{at}mayo.edu).

Objectives: Our aim was to examine whether gender-based differences in mortality after percutaneous coronary interventions (PCIs) have changed in the past 25 years.

Background: Women with coronary artery disease have a higher risk of adverse outcomes after PCIs than do men. Recent temporal trends in short-term and long-term mortality in women after PCIs are unknown.

Methods: We performed a retrospective cohort study of 18,885 consecutive, unique patients who underwent PCIs between 1979 and 1995 (early group, n = 7,904, 28% women) and between 1996 and 2004 (recent group, n = 10,981, 31% women). Thirty-day and long-term mortality were compared by gender.

Results: Compared with men, women undergoing PCIs were older and more likely to have diabetes mellitus, hypertension, or hypercholesterolemia. Overall, PCI was successful in 89% of women and 90% of men. In the recent group, 30-day mortality was significantly reduced compared with that in the early group in women (2.9% vs. 4.4%, p = 0.002) and men (2.2% vs. 2.8%, p = 0.04). However, long-term survival was similar between the early and recent groups among both men and women. After adjustment for risk factors, there was no difference between men and women from 1994 onward for either 30-day or long-term outcomes.

Conclusions: The 30-day mortality after PCI in men and women has decreased in the past 25 years. After accounting for baseline risks, no differences in short-term or long-term mortality were observed between men and women.

Abbreviations and Acronyms   ACC = American College of Cardiology   AHA = American Heart Association   PCI = percutaneous coronary intervention

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