Sex Differences in Characteristics, Treatments, and In-hospital Outcomes of Patients Undergoing Coronary Angiography or Intervention

Shi-Qun Chen; Jin Liu; Yang Zhou; Zhi-Dong Huang; Yun Xie; Hao-Zhang Huang; Xiao-Ming Yan; Yong-Yi Xie; Peng-Fei Hao; Yan Liang; Shao-Hong Dong; Xiao-Yu Huang; Li-Ling Chen; Ning Tan; Yong Liu; Ji-Yan Chen

doi:10.3389/fcvm.2022.878566

Sex Differences in Characteristics, Treatments, and In-hospital Outcomes of Patients Undergoing Coronary Angiography or Intervention

Front Cardiovasc Med. 2022 Apr 29:9:878566. doi: 10.3389/fcvm.2022.878566. eCollection 2022.

Authors

Shi-Qun Chen^{1

2}, Jin Liu^{1

2}, Yang Zhou^{1

2}, Zhi-Dong Huang^{1

2}, Yun Xie^{1

2}, Hao-Zhang Huang^{1

2

3}, Xiao-Ming Yan⁴, Yong-Yi Xie⁴, Peng-Fei Hao⁴, Yan Liang⁵, Shao-Hong Dong⁶, Xiao-Yu Huang⁷, Li-Ling Chen⁸, Ning Tan^{1

2

3

9}, Yong Liu^{1

2

3

9}, Ji-Yan Chen^{1

2

3

9}

Affiliations

¹ Department of Cardiology, Guangdong Provincial People's Hospital, Guangdong Cardiovascular Institute, Guangdong Academy of Medical Sciences, Guangzhou, China.
² Department of Guangdong Provincial Key Laboratory of Coronary Heart Disease Prevention, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China.
³ The Second School of Clinical Medicine, Southern Medical University, Guangzhou, China.
⁴ Department of Information Technology, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China.
⁵ Department of Cardiology, Maoming People's Hospital, Maoming, China.
⁶ Department of Cardiology, Shenzhen People's Hospital, Shenzhen, China.
⁷ Department of Cardiology, Yangjiang People's Hospital, Yangjiang, China.
⁸ Department of Cardiology, Longyan First Affiliated Hospital of Fujian Medical University, Longyan, China.
⁹ Guangdong Provincial People's Hospital, School of Medicine, South China University of Technology, Guangzhou, China.

Abstract

Background: Whether women have a higher risk of adverse events compared with men following coronary angiography (CAG) and percutaneous coronary intervention (PCI) remains controversial. We aimed to investigate the sex differences in characteristics, treatments and outcomes among patients undergoing CAG and PCI in a large Chinese cohort.

Methods: We analyzed patients undergoing CAG and/or PCI in this multi-center registry cohort study Cardiorenal ImprovemeNt II (CIN-II) in 5 Chinese tertiary hospitals from 2007 to 2020. Clinical characteristics, treatment (discharge medication and PCI) and in-hospital outcomes (mortality and major bleeding) were compared between women and men.

Results: Totally 141,459 patients underwent CAG (44,362 [31.4%] women), of which 69,345 patients underwent PCI (15,376 [22.2%] women). Women were older (64.4 vs. 60.8 years), had more chronic comorbidities and lower PCI rate for stable coronary artery disease (CAD) than men (52.8 vs. 64.2%). Women received less CAG and PCI procedures. Among women undergoing PCI they received similar discharge medication treatment. In addition, women undergoing PCI had mildly lower rate of major bleeding (0.2 vs. 0.3%, P = 0.033) but higher in-hospital mortality (1.2 vs. 0.8%, P < 0.001). After adjustment, women had a higher risk in the major bleeding (adjusted odds ratio, 2.04 [95% CI: 1.07 to 3.62]), and the in-hospital mortality (adjusted odds ratio, 1.87 [95% CI: 1.36 to 2.56]).

Conclusion: Among our Chinese cohort, women are older with more chronic comorbidities, receiving less PCI procedure and similar discharge medication treatment. Women have nearly 90% higher risk of in-hospital mortality and over 1-fold increased risk of major bleeding after PCI compared with men.

Keywords: coronary angiography; coronary artery disease; outcome; percutaneous coronary intervention; sex differences.