Gender differences in coronary angiography, subsequent interventions, and outcomes among patients with acute coronary syndromes

Gudny Stella Gudnadottir*, Karl Andersen, Inga Sigurros Thrainsdottir, Stefan Karl James, Bo Lagerqvist, Thorarinn Gudnason

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

25 Citations (Scopus)

Abstract

Background: The objective was to investigate whether gender disparities are found in referrals of patients with acute coronary syndromes to percutaneous coronary interventions (PCIs) or coronary artery bypass grafting (CABG) and, furthermore, to study gender differences in complications and mortality. Methods: All consecutive coronary angiographies (CAs) and PCIs performed in Sweden and Iceland are prospectively registered in the Swedish Coronary Angiography and Angioplasty Registry. For the present analysis, data of patients with acute coronary syndromes, enrolled in 2007-2011, were used to analyze gender differences in revascularization, in-hospital complications, and 30-day mortality. Results: A total of 106,881 CAs were performed during the study period. In patients with significant coronary artery disease, the adjusted odds ratio (OR) for women to undergo PCI compared with men was 0.95 (95% CI 0.92-0.99) and 0.81 (0.76-0.87) for referrals to CABG. In patients with 1-vessel disease, women were less likely to undergo PCI than men, but women with 2- or 3-vessel or left main stem disease were more likely to undergo PCI. All in-hospital complications after CA followed by PCI were more frequent among women (adjusted OR 1.58 [1.47-1.70]). There was no gender difference in adjusted 30-day mortality after PCI (1.02 [0.92-1.12]) and after CABG (0.97 [0.72-1.31]). Conclusions: After CA showing 1-vessel disease, women as compared with men were less likely to undergo PCI. In the group with 2- or 3-vessel disease or left main stem stenosis, women were more likely to undergo PCI but less likely to undergo CABG. However, there was no gender difference in 30-day mortality.

Original languageEnglish
Pages (from-to)65-74
Number of pages10
JournalAmerican Heart Journal
Volume191
DOIs
Publication statusPublished - Sept 2017

Bibliographical note

Publisher Copyright:
© 2017 Elsevier Inc.

Other keywords

  • Kransæðasjúkdómar
  • Röntgenrannsóknir
  • CAR12
  • Acute Coronary Syndrome
  • Coronary Angiography
  • Sex Distribution

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