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Sex-based differences in outcomes after percutaneous coronary intervention for acute myocardial infarction: a report from TRANSLATE-ACS.

dc.contributor.author Hess, Connie Ng
dc.contributor.author McCoy, LA
dc.contributor.author Duggirala, HJ
dc.contributor.author Tavris, DR
dc.contributor.author O'Callaghan, K
dc.contributor.author Douglas, Pamela Susan
dc.contributor.author Peterson, Eric David
dc.contributor.author Wang, TY
dc.coverage.spatial England
dc.date.accessioned 2017-07-06T15:57:15Z
dc.date.available 2017-07-06T15:57:15Z
dc.date.issued 2014-02-07
dc.identifier https://www.ncbi.nlm.nih.gov/pubmed/24510115
dc.identifier jah3431
dc.identifier.uri https://hdl.handle.net/10161/15014
dc.description.abstract BACKGROUND: Data regarding sex-based outcomes after percutaneous coronary intervention (PCI) for myocardial infarction are mixed. We sought to examine whether sex differences in outcomes exist in contemporary practice. METHODS AND RESULTS: We examined acute myocardial infarction patients undergoing PCI between April 2010 and October 2012 at 210 US hospitals participating in the Treatment with Adenosine Diphosphate Receptor Inhibitors: Longitudinal Assessment of Treatment Patterns and Events after Acute Coronary Syndrome (TRANSLATE-ACS) observational study. Outcomes included 1-year risk of major adverse cardiac events and bleeding according to Global Utilization of Strategies To Open Occluded Arteries (GUSTO) and Bleeding Academic Research Consortium (BARC) definitions. Among 6218 patients, 27.5% (n=1712) were female. Compared with men, women were older, had more comorbidities, and had lower functional status. Use of multivessel PCI and drug-eluting stents was similar between sexes, while women received less prasugrel. Unadjusted cumulative incidence of 1-year major adverse cardiac events was higher for women than for men (15.7% versus 13.6%, P=0.02), but female sex was no longer associated with higher incidence of major adverse cardiac events after multivariable adjustment (hazard ratio 0.98, 95% CI 0.83 to 1.15). Female sex was associated with higher risks of post-PCI GUSTO bleeding (9.1% versus 5.7%, P<0.0001) and postdischarge BARC bleeding (39.6% versus 27.9%, P<0.0001). Differences persisted after adjustment (GUSTO: hazard ratio 1.32, 95% CI 1.06 to 1.64; BARC: incidence rate ratio 1.42, 95% CI 1.27 to 1.56). CONCLUSIONS: Female and male myocardial infarction patients undergoing PCI differ regarding demographic, clinical, and treatment profiles. These differences appear to explain the higher observed major adverse cardiac event rate but not higher adjusted bleeding risk for women versus men.
dc.language eng
dc.relation.ispartof J Am Heart Assoc
dc.relation.isversionof 10.1161/JAHA.113.000523
dc.subject acute myocardial infarction
dc.subject major adverse cardiac events
dc.subject percutaneous coronary intervention
dc.subject sex‐based outcomes
dc.subject Age Factors
dc.subject Aged
dc.subject Comorbidity
dc.subject Drug-Eluting Stents
dc.subject Female
dc.subject Health Status Disparities
dc.subject Healthcare Disparities
dc.subject Hemorrhage
dc.subject Humans
dc.subject Longitudinal Studies
dc.subject Male
dc.subject Middle Aged
dc.subject Myocardial Infarction
dc.subject Percutaneous Coronary Intervention
dc.subject Platelet Aggregation Inhibitors
dc.subject Prospective Studies
dc.subject Purinergic P2Y Receptor Antagonists
dc.subject Risk Factors
dc.subject Sex Factors
dc.subject Time Factors
dc.subject Treatment Outcome
dc.subject United States
dc.title Sex-based differences in outcomes after percutaneous coronary intervention for acute myocardial infarction: a report from TRANSLATE-ACS.
dc.type Journal article
pubs.author-url https://www.ncbi.nlm.nih.gov/pubmed/24510115
pubs.begin-page e000523
pubs.issue 1
pubs.organisational-group Clinical Science Departments
pubs.organisational-group Duke
pubs.organisational-group Duke Clinical Research Institute
pubs.organisational-group Institutes and Centers
pubs.organisational-group Medicine
pubs.organisational-group Medicine, Cardiology
pubs.organisational-group School of Medicine
pubs.publication-status Published online
pubs.volume 3
dc.identifier.eissn 2047-9980


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