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Table 8-1. In-Hospital Death and Myocardial Infarction after PCI by Gender

Study (Year)

No. Women/No. Men

Women (%)

Men (%)

Adjusted OR (95% CI)

Peterson (2001)

35,571/74,1 37

Death

1.8

1 .0

1.07 (0.9-1.2)

MI

1.5

1 .2

1.25 (1.1-1.4)

Jacobs (2002)

895/1,629

Death

2.2

1 .3

1.6 (0.76-3.35)

MI

0.2

0.7

Lansky (2002)

2,077/5,295

Death

1 .4

0.7

2.28 (1.1 5-4.55)

Watanabe (2001)

29,227/53,556

Death

1 .2

0.6

1.65 (1.33-2.04)

Malenka (2002)

3,983/8,057

Death

1 .04

0.79

1 .24 (0.96-1 .60)

MI

1 .71

1.36

1.02 (0.85-1.24)

CI, confidence interval; MI, myocardial infarction; OR, odds ratio.

CI, confidence interval; MI, myocardial infarction; OR, odds ratio.

despite better LV function, women tend to have higher incidence of congestive heart failure and more functional impairment after revascularization than men.2

Early reports of patients undergoing balloon angioplasty showed lower procedural success rates in women. However, recent studies have reported similar procedural success rates (>90%) in both groups.3,4,6-8 In addition, earlier registry studies showed that women had higher in-hospital mortality rates after PCI even after adjusting for baseline comor-bidites.3,9 Improved morbidity and mortality outcomes have been reported in more recent studies, despite the older age in women.3-5,10-13 Table 8-1 shows the recently published data regarding rates of in-hospital death and MI by gender. Table 8-1 includes large published studies since 2000 that reported age and risk factor adjusted odds ratios. Even though there are variations in each of the studies, they show no gender difference in inhospital mortality and morbidity rates. With the recent advances in PCI with newer-generation stents, balloons, smaller sheath sizes and catheters, and advances in adjunctive pharmacotherapies, adjusted long-term mortality and morbidity rates after PCI are also similar between men and women (Table 8-2;

Fig. 8-1).3,4,7 There has been much controversy surrounding less frequent utilization of diagnostic cath-eterization and delays in PCI in women compared with men.14 These issues are addressed further in the discussions of ACS and MI.

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