Gender differences in in-hospital clinical outcomes after percutaneous coronary interventions: An insight from a Japanese multicenter registry

Yohei Numasawa, Shun Kosaka, Hiroaki Miyata, Shigetaka Noma, Masahiro Suzuki, Shiro Ishikawa, Iwao Nakamura, Yutaro Nishi, Takahiro Ohki, Koji Negishi, Toshiyuki Takahashi, Keiichi Fukuda

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Abstract

Background: Gender differences in clinical outcomes after percutaneous coronary intervention (PCI) among different age groups are controversial in the era of drug-eluting stents, especially among the Asian population who are at higher risk for bleeding complications. Methods and Results: We analyzed data from 10,220 patients who underwent PCI procedures performed at 14 Japanese hospitals from September 2008 to April 2013. A total of 2,106 (20.6%) patients were women. Women were older (72.7±9.7 vs 66.6±10.8 years, p< 0.001), and had a lower body mass index (23.4±4.0 vs 24.3±3.5, p<0.001), with a higher prevalence of hypertension (p<0.001), hyperlipidemia (p<0.001), insulin-dependent diabetes (p<0.001), renal failure (p<0.001), and heart failure (p<0.001) compared with men. Men tended to have more bifurcation lesions (p = 0.003) and chronic totally occluded lesions (p<0.001) than women. Crude overall complications (14.8% vs 9.5%, p<0.001) and the rate of bleeding complications (5.3% vs 2.8%, p<0.001) were significantly higher in women than in men. On multivariate analysis in the total cohort, female sex was an independent predictor of overall complications (OR, 1.47; 95% CI, 1.26 -1.71; p<0.001) and bleeding complications (OR, 1.74; 95% CI, 1.36-2.24; p<0.001) after adjustment for confounding variables. A similar trend was observed across the middle-aged group (≥55 and <75 years) and old age group (≥75 years). Conclusions: Women are at higher risk than men for post-procedural complications after PCI, regardless of age.

Original languageEnglish
Article numbere0116496
JournalPLoS One
Volume10
Issue number1
DOIs
Publication statusPublished - 2015 Jan 30

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Percutaneous Coronary Intervention
gender differences
Registries
Stents
hemorrhage
Medical problems
Hemorrhage
Insulin
Age Groups
middle-aged adults
Drug-Eluting Stents
Confounding Factors (Epidemiology)
Pharmaceutical Preparations
hyperlipidemia
renal failure
heart failure
Hyperlipidemias
hypertension
multivariate analysis
Renal Insufficiency

ASJC Scopus subject areas

  • Medicine(all)
  • Biochemistry, Genetics and Molecular Biology(all)
  • Agricultural and Biological Sciences(all)

Cite this

Gender differences in in-hospital clinical outcomes after percutaneous coronary interventions : An insight from a Japanese multicenter registry. / Numasawa, Yohei; Kosaka, Shun; Miyata, Hiroaki; Noma, Shigetaka; Suzuki, Masahiro; Ishikawa, Shiro; Nakamura, Iwao; Nishi, Yutaro; Ohki, Takahiro; Negishi, Koji; Takahashi, Toshiyuki; Fukuda, Keiichi.

In: PLoS One, Vol. 10, No. 1, e0116496, 30.01.2015.

Research output: Contribution to journalArticle

Numasawa, Yohei ; Kosaka, Shun ; Miyata, Hiroaki ; Noma, Shigetaka ; Suzuki, Masahiro ; Ishikawa, Shiro ; Nakamura, Iwao ; Nishi, Yutaro ; Ohki, Takahiro ; Negishi, Koji ; Takahashi, Toshiyuki ; Fukuda, Keiichi. / Gender differences in in-hospital clinical outcomes after percutaneous coronary interventions : An insight from a Japanese multicenter registry. In: PLoS One. 2015 ; Vol. 10, No. 1.
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abstract = "Background: Gender differences in clinical outcomes after percutaneous coronary intervention (PCI) among different age groups are controversial in the era of drug-eluting stents, especially among the Asian population who are at higher risk for bleeding complications. Methods and Results: We analyzed data from 10,220 patients who underwent PCI procedures performed at 14 Japanese hospitals from September 2008 to April 2013. A total of 2,106 (20.6{\%}) patients were women. Women were older (72.7±9.7 vs 66.6±10.8 years, p< 0.001), and had a lower body mass index (23.4±4.0 vs 24.3±3.5, p<0.001), with a higher prevalence of hypertension (p<0.001), hyperlipidemia (p<0.001), insulin-dependent diabetes (p<0.001), renal failure (p<0.001), and heart failure (p<0.001) compared with men. Men tended to have more bifurcation lesions (p = 0.003) and chronic totally occluded lesions (p<0.001) than women. Crude overall complications (14.8{\%} vs 9.5{\%}, p<0.001) and the rate of bleeding complications (5.3{\%} vs 2.8{\%}, p<0.001) were significantly higher in women than in men. On multivariate analysis in the total cohort, female sex was an independent predictor of overall complications (OR, 1.47; 95{\%} CI, 1.26 -1.71; p<0.001) and bleeding complications (OR, 1.74; 95{\%} CI, 1.36-2.24; p<0.001) after adjustment for confounding variables. A similar trend was observed across the middle-aged group (≥55 and <75 years) and old age group (≥75 years). Conclusions: Women are at higher risk than men for post-procedural complications after PCI, regardless of age.",
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T2 - An insight from a Japanese multicenter registry

AU - Numasawa, Yohei

AU - Kosaka, Shun

AU - Miyata, Hiroaki

AU - Noma, Shigetaka

AU - Suzuki, Masahiro

AU - Ishikawa, Shiro

AU - Nakamura, Iwao

AU - Nishi, Yutaro

AU - Ohki, Takahiro

AU - Negishi, Koji

AU - Takahashi, Toshiyuki

AU - Fukuda, Keiichi

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N2 - Background: Gender differences in clinical outcomes after percutaneous coronary intervention (PCI) among different age groups are controversial in the era of drug-eluting stents, especially among the Asian population who are at higher risk for bleeding complications. Methods and Results: We analyzed data from 10,220 patients who underwent PCI procedures performed at 14 Japanese hospitals from September 2008 to April 2013. A total of 2,106 (20.6%) patients were women. Women were older (72.7±9.7 vs 66.6±10.8 years, p< 0.001), and had a lower body mass index (23.4±4.0 vs 24.3±3.5, p<0.001), with a higher prevalence of hypertension (p<0.001), hyperlipidemia (p<0.001), insulin-dependent diabetes (p<0.001), renal failure (p<0.001), and heart failure (p<0.001) compared with men. Men tended to have more bifurcation lesions (p = 0.003) and chronic totally occluded lesions (p<0.001) than women. Crude overall complications (14.8% vs 9.5%, p<0.001) and the rate of bleeding complications (5.3% vs 2.8%, p<0.001) were significantly higher in women than in men. On multivariate analysis in the total cohort, female sex was an independent predictor of overall complications (OR, 1.47; 95% CI, 1.26 -1.71; p<0.001) and bleeding complications (OR, 1.74; 95% CI, 1.36-2.24; p<0.001) after adjustment for confounding variables. A similar trend was observed across the middle-aged group (≥55 and <75 years) and old age group (≥75 years). Conclusions: Women are at higher risk than men for post-procedural complications after PCI, regardless of age.

AB - Background: Gender differences in clinical outcomes after percutaneous coronary intervention (PCI) among different age groups are controversial in the era of drug-eluting stents, especially among the Asian population who are at higher risk for bleeding complications. Methods and Results: We analyzed data from 10,220 patients who underwent PCI procedures performed at 14 Japanese hospitals from September 2008 to April 2013. A total of 2,106 (20.6%) patients were women. Women were older (72.7±9.7 vs 66.6±10.8 years, p< 0.001), and had a lower body mass index (23.4±4.0 vs 24.3±3.5, p<0.001), with a higher prevalence of hypertension (p<0.001), hyperlipidemia (p<0.001), insulin-dependent diabetes (p<0.001), renal failure (p<0.001), and heart failure (p<0.001) compared with men. Men tended to have more bifurcation lesions (p = 0.003) and chronic totally occluded lesions (p<0.001) than women. Crude overall complications (14.8% vs 9.5%, p<0.001) and the rate of bleeding complications (5.3% vs 2.8%, p<0.001) were significantly higher in women than in men. On multivariate analysis in the total cohort, female sex was an independent predictor of overall complications (OR, 1.47; 95% CI, 1.26 -1.71; p<0.001) and bleeding complications (OR, 1.74; 95% CI, 1.36-2.24; p<0.001) after adjustment for confounding variables. A similar trend was observed across the middle-aged group (≥55 and <75 years) and old age group (≥75 years). Conclusions: Women are at higher risk than men for post-procedural complications after PCI, regardless of age.

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