The changing in-hospital mortality of women undergoing percutaneous transluminal coronary angioplasty

M. R. Bell, David Holmes, P. B. Berger, K. N. Garratt, Kent R Bailey, B. J. Gersh

Research output: Contribution to journalArticle

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Abstract

Objective. - To compare in-hospital mortality among women and men undergoing percutaneous transluminal coronary angioplasty (PTCA) and determine whether mortality differences have changed recently. Design. - A retrospective cohort study. Setting. - Tertiary referral institution. Patients. - Consecutive series of 3557 patients (27% women) who underwent 4071 PTCA procedures. Two cohorts were analyzed: patients treated between 1979 and 1987 (n=1970) and those treated between 1988 and 1990 (n=2101). Main Outcome Measures. - In-hospital and periprocedural mortality. Results. - Women were older than men (P<.001) and more had class III or IV angina (P<.001), unstable angina (P<.001), angina at rest (P<.001), cardiac failure (P<.001), and diabetes mellitus, hypertension, and hypercholesterolemia (P<.001). The PTCA was successful in 85% of women and 86% of men with an in- hospital mortality rate of 4.2% and 2.7%, respectively (P=.005). No significant change in mortality occurred in men between the early (2.2%) and late (3.1%) eras in contrast to a significant increase among women, 2.9% to 5.4% (P=.04). Periprocedural mortalities for women and men between 1979 and 1987 were 1.0% and 1.2% (P=not significant) and between 1988 and 1990 were 2.9% and 1.4% (P=.02), respectively. The multivariate odds ratio of in- hospital mortality for women vs men was 1.51 (95% confidence interval, 1.00 to 2.29; P=.05), although six other baseline variables were more powerful predictors of in-hospital mortality. Accounting for body surface area resulted in no significant association between gender and in-hospital mortality. Periprocedural mortality was not independently associated with gender. Conclusions. - In-hospital mortality among women has increased in recent years, but their higher mortality compared with men is related more to the severity of their underlying disease rather than gender alone.

Original languageEnglish (US)
Pages (from-to)2091-2095
Number of pages5
JournalJournal of the American Medical Association
Volume269
Issue number16
DOIs
StatePublished - 1993

Fingerprint

Coronary Balloon Angioplasty
Hospital Mortality
Mortality
Unstable Angina
Body Surface Area
Hypercholesterolemia
Diabetes Mellitus
Cohort Studies
Referral and Consultation
Heart Failure
Retrospective Studies
Odds Ratio
Outcome Assessment (Health Care)
Confidence Intervals
Hypertension

ASJC Scopus subject areas

  • Medicine(all)

Cite this

The changing in-hospital mortality of women undergoing percutaneous transluminal coronary angioplasty. / Bell, M. R.; Holmes, David; Berger, P. B.; Garratt, K. N.; Bailey, Kent R; Gersh, B. J.

In: Journal of the American Medical Association, Vol. 269, No. 16, 1993, p. 2091-2095.

Research output: Contribution to journalArticle

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title = "The changing in-hospital mortality of women undergoing percutaneous transluminal coronary angioplasty",
abstract = "Objective. - To compare in-hospital mortality among women and men undergoing percutaneous transluminal coronary angioplasty (PTCA) and determine whether mortality differences have changed recently. Design. - A retrospective cohort study. Setting. - Tertiary referral institution. Patients. - Consecutive series of 3557 patients (27{\%} women) who underwent 4071 PTCA procedures. Two cohorts were analyzed: patients treated between 1979 and 1987 (n=1970) and those treated between 1988 and 1990 (n=2101). Main Outcome Measures. - In-hospital and periprocedural mortality. Results. - Women were older than men (P<.001) and more had class III or IV angina (P<.001), unstable angina (P<.001), angina at rest (P<.001), cardiac failure (P<.001), and diabetes mellitus, hypertension, and hypercholesterolemia (P<.001). The PTCA was successful in 85{\%} of women and 86{\%} of men with an in- hospital mortality rate of 4.2{\%} and 2.7{\%}, respectively (P=.005). No significant change in mortality occurred in men between the early (2.2{\%}) and late (3.1{\%}) eras in contrast to a significant increase among women, 2.9{\%} to 5.4{\%} (P=.04). Periprocedural mortalities for women and men between 1979 and 1987 were 1.0{\%} and 1.2{\%} (P=not significant) and between 1988 and 1990 were 2.9{\%} and 1.4{\%} (P=.02), respectively. The multivariate odds ratio of in- hospital mortality for women vs men was 1.51 (95{\%} confidence interval, 1.00 to 2.29; P=.05), although six other baseline variables were more powerful predictors of in-hospital mortality. Accounting for body surface area resulted in no significant association between gender and in-hospital mortality. Periprocedural mortality was not independently associated with gender. Conclusions. - In-hospital mortality among women has increased in recent years, but their higher mortality compared with men is related more to the severity of their underlying disease rather than gender alone.",
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T1 - The changing in-hospital mortality of women undergoing percutaneous transluminal coronary angioplasty

AU - Bell, M. R.

AU - Holmes, David

AU - Berger, P. B.

AU - Garratt, K. N.

AU - Bailey, Kent R

AU - Gersh, B. J.

PY - 1993

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N2 - Objective. - To compare in-hospital mortality among women and men undergoing percutaneous transluminal coronary angioplasty (PTCA) and determine whether mortality differences have changed recently. Design. - A retrospective cohort study. Setting. - Tertiary referral institution. Patients. - Consecutive series of 3557 patients (27% women) who underwent 4071 PTCA procedures. Two cohorts were analyzed: patients treated between 1979 and 1987 (n=1970) and those treated between 1988 and 1990 (n=2101). Main Outcome Measures. - In-hospital and periprocedural mortality. Results. - Women were older than men (P<.001) and more had class III or IV angina (P<.001), unstable angina (P<.001), angina at rest (P<.001), cardiac failure (P<.001), and diabetes mellitus, hypertension, and hypercholesterolemia (P<.001). The PTCA was successful in 85% of women and 86% of men with an in- hospital mortality rate of 4.2% and 2.7%, respectively (P=.005). No significant change in mortality occurred in men between the early (2.2%) and late (3.1%) eras in contrast to a significant increase among women, 2.9% to 5.4% (P=.04). Periprocedural mortalities for women and men between 1979 and 1987 were 1.0% and 1.2% (P=not significant) and between 1988 and 1990 were 2.9% and 1.4% (P=.02), respectively. The multivariate odds ratio of in- hospital mortality for women vs men was 1.51 (95% confidence interval, 1.00 to 2.29; P=.05), although six other baseline variables were more powerful predictors of in-hospital mortality. Accounting for body surface area resulted in no significant association between gender and in-hospital mortality. Periprocedural mortality was not independently associated with gender. Conclusions. - In-hospital mortality among women has increased in recent years, but their higher mortality compared with men is related more to the severity of their underlying disease rather than gender alone.

AB - Objective. - To compare in-hospital mortality among women and men undergoing percutaneous transluminal coronary angioplasty (PTCA) and determine whether mortality differences have changed recently. Design. - A retrospective cohort study. Setting. - Tertiary referral institution. Patients. - Consecutive series of 3557 patients (27% women) who underwent 4071 PTCA procedures. Two cohorts were analyzed: patients treated between 1979 and 1987 (n=1970) and those treated between 1988 and 1990 (n=2101). Main Outcome Measures. - In-hospital and periprocedural mortality. Results. - Women were older than men (P<.001) and more had class III or IV angina (P<.001), unstable angina (P<.001), angina at rest (P<.001), cardiac failure (P<.001), and diabetes mellitus, hypertension, and hypercholesterolemia (P<.001). The PTCA was successful in 85% of women and 86% of men with an in- hospital mortality rate of 4.2% and 2.7%, respectively (P=.005). No significant change in mortality occurred in men between the early (2.2%) and late (3.1%) eras in contrast to a significant increase among women, 2.9% to 5.4% (P=.04). Periprocedural mortalities for women and men between 1979 and 1987 were 1.0% and 1.2% (P=not significant) and between 1988 and 1990 were 2.9% and 1.4% (P=.02), respectively. The multivariate odds ratio of in- hospital mortality for women vs men was 1.51 (95% confidence interval, 1.00 to 2.29; P=.05), although six other baseline variables were more powerful predictors of in-hospital mortality. Accounting for body surface area resulted in no significant association between gender and in-hospital mortality. Periprocedural mortality was not independently associated with gender. Conclusions. - In-hospital mortality among women has increased in recent years, but their higher mortality compared with men is related more to the severity of their underlying disease rather than gender alone.

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