Sex‐based differences in bleeding and long‐term adverse events after percutaneous coronary intervention in older patients with coronary artery disease

Objectives

Differences in outcomes for women and men after percutaneous coronary intervention (PCI) in older patients remain controversial. Herein, we compared 2‐year outcomes by sex in Chinese older patients undergoing PCI.

Methods

A total of 4926 consecutive patients (33.6% women, age ≥60 years, mean age 67.4 ± 5.7 years) who underwent PCI at a single center in China from January 2013 to December 2013 were included in this study. The primary endpoint was 2‐year risk of bleeding according to the Bleeding Academic Research Consortium definitions. The secondary endpoints included 2‐year risk of major adverse cardiovascular and cerebrovascular events (MACCE). Hazard ratios were generated using multivariable Cox regression.

Results

Compared with men, women had significantly higher rates of in‐hospital all‐cause mortality (0.8% vs 0.2%, P = 0.001), cardiac death (0.5% vs 0.1%, P = 0.006), MACCE (2.4% vs 1.5%, P = 0.017), and bleeding (0.4% vs 0.1%, P = 0.015). At 2‐year follow up, there were no differences between men and women for all‐cause mortality (1.9% vs 1.8%, P = 0.839) and 2‐year MACCE (13.1% vs 11.8%, P = 0.216). However, women had a higher risk of 2‐year bleeding (9.2% vs 6.2%, P < 0.001), which persisted after adjusting for baseline differences and treatment characteristics (hazard ratio 1.35, 95% confidence interval 1.06‐1.71; P = 0.014).

Conclusion

We found that older women undergoing PCI were at increased risk of 2‐year bleeding compared with men. Further dedicated studies are needed to confirm these findings.