Objective: To assess gender differences among patients subjected to percutaneous coronary intervention (PCI) according to data of the "Register of performed operations of percutaneous transluminal coronary angioplasty (PTCA)".
Materials and methods: The Register was conducted from 1996 to 2012 years and comprised 4890 patients (4121 men and 769 women).
Results: Women compared to men were older (58.2+/-8.6 vs 53.4+/-8.3 years; <0.001), had higher body mass index (31.4+/-5.3 vs 29.0+/-4.4 kg/m2; <0.001), level of total cholesterol (5.6+/-1.5 vs 5.3+/-1.3 mmol/l%; <0.001), systolic (141.1+/-22.2 vs 135.1+/-20.8 mmHg, <0.001) and diastolic blood pressure (86.5+/-11.8 vs 85.4+/-12.0 mmHg; =0.014). Compared to male cohort females more often had diabetes mellitus (22.5% vs 10.0%; <0.001), arterial hypertension (92.1 vs 75.6%; <0.001), family history of ischemic heart disease (IHD) (31.3 vs 23.4%; <0.001). Moreover, severe functional classes of effort angina (class III-IV 62.8 vs 50.0%; <0.001) and heart failure (NYHA class III-IV 28.1 vs 13.4%; <0.001) were more often detected in women. In men more frequent were smoking (45.4 vs 9.9%; <0.001), alcohol consumption (26.6 vs 9.0%; <0.001) and history of myocardial infarction (51.8 vs 40.2%; <0.001). Linear heart dimensions were larger in men. Men had more severe left ventricular (LV) asynergy (15.9+/-15.1 vs 13.7+/-14.7%; <0.001) and lower LV ejection fraction (54.5+/-8.7 vs 55.4+/-8.6 %; =0.03). As compared with men, portion of women subjected to primary PTCA was higher (14.3 vs 9.2%; <0.001), likewise coronary stenting was more often performed in women (93.6 vs 88.5%; <0.001). Optimal angiographic results were more frequently achieved in women (97.9 vs 96.4%; =0.04). Incidence of post-punctional hematoma was higher in female cohort (15.0 vs 4.6%; <0.001). There were no significant differences between men and women in post-operative mortality and rate of major adverse noncardiac events after primary and planned PTCA.
Conclusion: Despite the detected clinical, functional, and echocardiographic gender differences both for men and women PCI was safe and highly efficient method of IHD treatment.
Keywords: gender differences; ischemic heart disease; percutaneous coronary intervention; register.