Gender differences in patients with percutaneous coronary intervention: the Armenian experience

Abstract

Background: Coronary artery disease (CAD) is the leading cause of morbidity and mortality throughout the world. Scientists are still debating whether women benefit from invasive treatment strategy of CAD as men do. This study assessed gender differences in perioperative characteristics), 3-year event-free survival from major adverse cardiac and cerebrovascular events (MACCE) and quality of life (QoL) in patients who underwent percutaneous coronary intervention (PCI). Methods: The study utilized an observational, retrospective cohort design. The study population included all CAD patients who underwent PCI from 2006-2008 at Nork Marash Medical Center. Data were collected from the patient medical records and patient telephone interviews. Results: Among 485 participants included in the analysis, 419 (86%) were men. Women on average were older, more hypertensive, more obese, and had significantly higher rates of diabetes. Event-free survival from MACCE at the median follow up was 79% (95% CI 0.66 -0.87) for women and 74% (95% CI 0.69-0.78) for men. An interaction analysis revealed a differential effect of diabetes by sex 0.14 (95 % CI 0.05- 0.43). After adjustment for arrhythmia, men with diabetes had better event-free survival from MACCE (HR =0.38, 95% CI: 0.18-0.8) than men without diabetes (HR= 2.6; 95%CI: 1.1-5.9). The QoL analysis showed that women had worse mental and physical composite scores (p < 0.05). Conclusion: Diabetes status and sex strongly interact with MACCE. In non diabetic population women have significantly better long-term survival than men, while the opposite was observed in diabetic population. According to the study results diabetes have significant negative impact in determining outcomes only in women patient.