Improved outcomes for women undergoing contemporary percutaneous coronary intervention: A report from the national heart, lung, and blood institute dynamic registry

Alice K. Jacobs, Janet M. Johnston, Amelia Haviland, Maria Mori Brooks, Sheryl F. Kelsey, David Holmes, David P. Faxon, David O. Williams, Katherine M. Detre

Research output: Contribution to journalArticle

156 Citations (Scopus)

Abstract

OBJECTIVES: The goal of this study was to determine whether women undergoing contemporary percutaneous coronary intervention (PCI) remain at increased risk in comparison with men and whether the outcomes in women have improved. BACKGROUND: Previous studies have shown that women treated with coronary angioplasty have a higher incidence of procedural morbidity and mortality than men. METHODS: Gender differences in wave 1 of the National Heart, Lung and Blood Institute (NHLBI) Dynamic registry were evaluated. Baseline characteristics and outcomes in women in the Dynamic registry were compared with those in women in the 1985-1986 and 1993-1994 NHLBI Percutaneous Transluminal Coronary Angioplasty (PTCA) registries. RESULTS: Women were older with a higher prevalence of diabetes mellitus, hypertension, congestive heart failure, unstable angina and single vessel disease in comparison with men. Although procedural success and in-hospital death (2.2% vs. 1.3%), myocardial infarction (MI) (2.3% vs. 3.0%) and coronary artery bypass graft surgery (CABG) (1.3% vs. 1.4%) were similar in women and men, respectively, one-year mortality (6.5% vs. 4.3%, p = 0.02) and combined end point of death/MI/CABG (18.3% vs. 14.4%, p = 0.03) were higher in women than in men. After controlling for other factors, gender was not a significant predictor of death or death plus MI at one year. Despite a higher risk profile in women in the Dynamic registry in comparison with women in the 1985-1986 NHLBI PTCA registry, in-hospital death/MI/CABG was lower (6.0% vs. 11.6%, p < 0.001). CONCLUSIONS: Despite persistent high-risk characteristics in women, gender differences in outcomes in patients undergoing contemporary PCI have decreased, and outcomes in women have improved.

Original languageEnglish (US)
Pages (from-to)1608-1614
Number of pages7
JournalJournal of the American College of Cardiology
Volume39
Issue number10
DOIs
StatePublished - May 15 2002

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National Heart, Lung, and Blood Institute (U.S.)
Percutaneous Coronary Intervention
Registries
Myocardial Infarction
Coronary Artery Bypass
Coronary Balloon Angioplasty
Transplants
Mortality
Unstable Angina
Angioplasty
Diabetes Mellitus

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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Improved outcomes for women undergoing contemporary percutaneous coronary intervention : A report from the national heart, lung, and blood institute dynamic registry. / Jacobs, Alice K.; Johnston, Janet M.; Haviland, Amelia; Mori Brooks, Maria; Kelsey, Sheryl F.; Holmes, David; Faxon, David P.; Williams, David O.; Detre, Katherine M.

In: Journal of the American College of Cardiology, Vol. 39, No. 10, 15.05.2002, p. 1608-1614.

Research output: Contribution to journalArticle

Jacobs, Alice K. ; Johnston, Janet M. ; Haviland, Amelia ; Mori Brooks, Maria ; Kelsey, Sheryl F. ; Holmes, David ; Faxon, David P. ; Williams, David O. ; Detre, Katherine M. / Improved outcomes for women undergoing contemporary percutaneous coronary intervention : A report from the national heart, lung, and blood institute dynamic registry. In: Journal of the American College of Cardiology. 2002 ; Vol. 39, No. 10. pp. 1608-1614.
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abstract = "OBJECTIVES: The goal of this study was to determine whether women undergoing contemporary percutaneous coronary intervention (PCI) remain at increased risk in comparison with men and whether the outcomes in women have improved. BACKGROUND: Previous studies have shown that women treated with coronary angioplasty have a higher incidence of procedural morbidity and mortality than men. METHODS: Gender differences in wave 1 of the National Heart, Lung and Blood Institute (NHLBI) Dynamic registry were evaluated. Baseline characteristics and outcomes in women in the Dynamic registry were compared with those in women in the 1985-1986 and 1993-1994 NHLBI Percutaneous Transluminal Coronary Angioplasty (PTCA) registries. RESULTS: Women were older with a higher prevalence of diabetes mellitus, hypertension, congestive heart failure, unstable angina and single vessel disease in comparison with men. Although procedural success and in-hospital death (2.2{\%} vs. 1.3{\%}), myocardial infarction (MI) (2.3{\%} vs. 3.0{\%}) and coronary artery bypass graft surgery (CABG) (1.3{\%} vs. 1.4{\%}) were similar in women and men, respectively, one-year mortality (6.5{\%} vs. 4.3{\%}, p = 0.02) and combined end point of death/MI/CABG (18.3{\%} vs. 14.4{\%}, p = 0.03) were higher in women than in men. After controlling for other factors, gender was not a significant predictor of death or death plus MI at one year. Despite a higher risk profile in women in the Dynamic registry in comparison with women in the 1985-1986 NHLBI PTCA registry, in-hospital death/MI/CABG was lower (6.0{\%} vs. 11.6{\%}, p < 0.001). CONCLUSIONS: Despite persistent high-risk characteristics in women, gender differences in outcomes in patients undergoing contemporary PCI have decreased, and outcomes in women have improved.",
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T1 - Improved outcomes for women undergoing contemporary percutaneous coronary intervention

T2 - A report from the national heart, lung, and blood institute dynamic registry

AU - Jacobs, Alice K.

AU - Johnston, Janet M.

AU - Haviland, Amelia

AU - Mori Brooks, Maria

AU - Kelsey, Sheryl F.

AU - Holmes, David

AU - Faxon, David P.

AU - Williams, David O.

AU - Detre, Katherine M.

PY - 2002/5/15

Y1 - 2002/5/15

N2 - OBJECTIVES: The goal of this study was to determine whether women undergoing contemporary percutaneous coronary intervention (PCI) remain at increased risk in comparison with men and whether the outcomes in women have improved. BACKGROUND: Previous studies have shown that women treated with coronary angioplasty have a higher incidence of procedural morbidity and mortality than men. METHODS: Gender differences in wave 1 of the National Heart, Lung and Blood Institute (NHLBI) Dynamic registry were evaluated. Baseline characteristics and outcomes in women in the Dynamic registry were compared with those in women in the 1985-1986 and 1993-1994 NHLBI Percutaneous Transluminal Coronary Angioplasty (PTCA) registries. RESULTS: Women were older with a higher prevalence of diabetes mellitus, hypertension, congestive heart failure, unstable angina and single vessel disease in comparison with men. Although procedural success and in-hospital death (2.2% vs. 1.3%), myocardial infarction (MI) (2.3% vs. 3.0%) and coronary artery bypass graft surgery (CABG) (1.3% vs. 1.4%) were similar in women and men, respectively, one-year mortality (6.5% vs. 4.3%, p = 0.02) and combined end point of death/MI/CABG (18.3% vs. 14.4%, p = 0.03) were higher in women than in men. After controlling for other factors, gender was not a significant predictor of death or death plus MI at one year. Despite a higher risk profile in women in the Dynamic registry in comparison with women in the 1985-1986 NHLBI PTCA registry, in-hospital death/MI/CABG was lower (6.0% vs. 11.6%, p < 0.001). CONCLUSIONS: Despite persistent high-risk characteristics in women, gender differences in outcomes in patients undergoing contemporary PCI have decreased, and outcomes in women have improved.

AB - OBJECTIVES: The goal of this study was to determine whether women undergoing contemporary percutaneous coronary intervention (PCI) remain at increased risk in comparison with men and whether the outcomes in women have improved. BACKGROUND: Previous studies have shown that women treated with coronary angioplasty have a higher incidence of procedural morbidity and mortality than men. METHODS: Gender differences in wave 1 of the National Heart, Lung and Blood Institute (NHLBI) Dynamic registry were evaluated. Baseline characteristics and outcomes in women in the Dynamic registry were compared with those in women in the 1985-1986 and 1993-1994 NHLBI Percutaneous Transluminal Coronary Angioplasty (PTCA) registries. RESULTS: Women were older with a higher prevalence of diabetes mellitus, hypertension, congestive heart failure, unstable angina and single vessel disease in comparison with men. Although procedural success and in-hospital death (2.2% vs. 1.3%), myocardial infarction (MI) (2.3% vs. 3.0%) and coronary artery bypass graft surgery (CABG) (1.3% vs. 1.4%) were similar in women and men, respectively, one-year mortality (6.5% vs. 4.3%, p = 0.02) and combined end point of death/MI/CABG (18.3% vs. 14.4%, p = 0.03) were higher in women than in men. After controlling for other factors, gender was not a significant predictor of death or death plus MI at one year. Despite a higher risk profile in women in the Dynamic registry in comparison with women in the 1985-1986 NHLBI PTCA registry, in-hospital death/MI/CABG was lower (6.0% vs. 11.6%, p < 0.001). CONCLUSIONS: Despite persistent high-risk characteristics in women, gender differences in outcomes in patients undergoing contemporary PCI have decreased, and outcomes in women have improved.

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