Background
Materials
Methods
Statistical analyses
Results
Patient characteristics
Variable | Women | Men |
P-value | OR (95%-CI) |
---|---|---|---|---|
Number of procedures | 22946 | 59358 | ||
Patient history: | ||||
Age [years] | 71.9 (64.8 – 78.3) | 66.7 (57.4 – 73.5) | <0.001 | |
Diabetes mellitus | 26.5% (5868/22154) | 20.2% (11537/57209) | <0.001 | 1.43 (1.38–1.48) |
Previous CABG | 8.2% (1885/22880) | 13.0% (7721/59200) | <0.001 | 0.60 (0.57–0.63) |
Previous PCI | 28.2% (6419/22747) | 34.7% (20432/58861) | <0.001 | 0.74 (0.72–0.76) |
Renal disease | 13.6% (2977/21943) | 13.3% (7510/56639) | 0.255 | 1.03 (0.98–1.07) |
Presentation: | ||||
STEMI | 18.2% (4182/22946) | 19.3% (11478/59358) | <0.001 | 0.95 (0.91–0.99) |
NSTE-ACS | 29.3% (6721/22946) | 27.6% (16370/59358) | 1.07 (1.04–1.11) | |
Stable CAD | 52.5% (12043/22946) | 53.1% (31510/59358) | 1a
| |
Cardiogenic shock | 1.7% (388/22945) | 1.5% (894/59355) | 0.055 | 1.12 (0.99–1.27) |
Symptoms of HF | 5.6% (1296/22945) | 5.0% (2952/59355) | <0.001 | 1.14 (1.07–1.22) |
Center volume stents/year | 1150 ± 613 | 1156 ± 623 | 0.364 | |
Target lesions: | ||||
RCA | 35.0% (8039/22946) | 34.5% (20508/59358) | 0.190 | 1.02 (0.99–1.05) |
LAD | 45.9% (10526/22946) | 41.0% (24358/59358) | <0.001 | 1.22 (1.18–1.26) |
CX | 23.6% (5412/22946) | 26.9% (15972/59358) | <0.001 | 0.84 (0.81–0.87) |
Left main stem | 2.2% (504/22946) | 2.6% (1538/59358) | 0.001 | 0.84 (0.76–0.93) |
Bypass graft | 1.8% (416/22946) | 3.5% (2107/593258) | <0.001 | 0.50 (0.45–0.56) |
Implanted stents per PCI | 1.40 ± 0.75 | 1.42 ± 0.76 | <0.001 | |
In-stent restenosis | 6.5% (1499/22914) | 7.3% (4300/59293) | <0.001 | 0.90 (0.84–0.95) |
Complex stenosis (≥ B2) | 66.6% (15032/22579) | 68.3% (39860/58402) | <0.001 | 0.93 (0.90–0.96) |
Usage of DES from 2005 to 2009
Stent diameter
Relative use of DES in women and men according to indication
Age dependent rate of DES use in women and men
Variables correlating with use of DES
Variable | Women | Men | ||
---|---|---|---|---|
DES [%] | OR (95%-CI) | DES [%] | OR (95%-CI) | |
Total stents | 28.2% (7857/27891) | 31.3% (22779/72813) | ||
Patient history: | ||||
Previous PCI yes/no | 43.9/22.3 | 2.74 (2.56–2.93) | 44.7/24.5 | 2.49 (2.39–2.59) |
Previous CABG yes/no | 36.3/27.5 | 1.50 (1.35–1.67) | 38.2/30.3 | 1.42 (1.35–1.50) |
Diabetes mellitus yes/no | 32.6/26.6 | 1.34 (1.25–1.43) | 36.3/30.3 | 1.31 (1.25–1.37) |
Renal disease yes/no | 23.7/29.5 | 0.74 (0.67–0.82) | 28.6/32.5 | 0.83 (0.78–0.88) |
Cardiogenic shock yes/no | 9.6/28.5 | 0.27 (0.18-0.38) | 13.7/31.6 | 0.34 (0.28-0.42) |
Symptoms of HF yes/no | 16.8/28.9 | 0.50 (0.42-0.59) | 21.3/31.8 | 0.58 (0.53-0.64) |
Lesion characteristics: | ||||
RCA | 24.9 | 1* | 26.9 | 1* |
LAD | 31.8 | 1.41 (1.32-1.51) | 35.8 | 1.51 (1.45-1.58) |
CX | 24.2 | 0.96 (0.89-1.04) | 28.9 | 1.10 (1.05-1.15) |
LMCA | 45.9 | 2.56 (2.13-3.08) | 50.1 | 2.73 (2.45-3.03) |
Bypass graft | 31.2 | 1.37 (1.12-1.67) | 30.0 | 1.16 (1.06-1.27) |
In-stent restenosis yes/no | 76.6/25.4 | 9.62 (8.45-10.95) | 75.0/28.5 | 7.55 (7.00-8.14) |
Complex stenosis (≥ B2) | 30.9/23.8 | 1.43 (1.34-1.52) | 33.6/27.4 | 1.34 (1.29-1.39) |
Explanatory variable |
P value | Adjusted odds ratio | 95%-CI |
---|---|---|---|
Age [10-year increase] in men | <0.001 | 0.81 | 0.79-0.82 |
Age [10-year increase] in women | <0.001 | 0.74 | 0.72-0.76 |
Female sex at age 75 years | 0.002 | 0.93 | 0.89-0.97 |
Female sex at age 80 years | <0.001 | 0.89 | 0.84-0.94 |
Diabetes | <0.001 | 1.29 | 1.24-1.35 |
STEMI vs. elective | <0.001 | 0.37 | 0.36-0.39 |
NSTEMI vs. elective | <0.001 | 0.64 | 0.61-0.66 |
Cardiogenic Shock | <0.001 | 0.46 | 0.38-0.55 |
Moderate symptoms of HF | <0.001 | 0.72 | 0.66-0.80 |
Previous PCI | <0.001 | 1.80 | 1.74-1.87 |
Previous CABG | <0.001 | 1.27 | 1.21-1.34 |
LAD | <0.001 | 1.63 | 1.57-1.68 |
Left main stem | <0.001 | 2.66 | 2.41-2.93 |
In-stent restenosis | <0.001 | 5.63 | 5.28-6.01 |
Complex stenosis (≥ B2) | <0.001 | 1.54 | 1.49-1.60 |
Stent diameter [for every mm] | <0.001 | 0.81 | 0.79-0.84 |
Adjuvant medical therapy, major adverse cardiac and cerebrovascular event (MACCE) and access site complications
Women | Men |
P-value | ||
---|---|---|---|---|
Medical therapy during PCI | ||||
Heparin (%) | Total | 85.5 | 84.8 | 0.160 |
STEMI | 90.7 | 91.0 | 0.710 | |
NSTEMI | 85.2 | 84.0 | 0.184 | |
stable CAD | 83.8 | 83.4 | 0.606 | |
LMW-Heparin (%) | Total | 3.4 | 3.7 | 0.211 |
STEMI | 4.9 | 4.4 | 0.461 | |
NSTEMI | 5.7 | 6.7 | 0.080 | |
stable CAD | 1.5 | 1.9 | 0.065 | |
Bivalirudin (%) | Total | 0.5 | 0.6 | 0.281 |
STEMI | 0.4 | 0.4 | 0.730 | |
NSTEMI | 0.9 | 0.8 | 0.893 | |
stable CAD | 0.4 | 0.6 | 0.113 | |
ASA i.v. (%) |
Total
|
43.9
|
41.6
|
<0.001
|
STEMI | 66.0 | 67.1 | 0.434 | |
NSTEMI
|
42.1
|
39.3
|
0.025
| |
stable CAD | 36.9 | 35.4 | 0.093 | |
ASA oral (%) |
Total
|
62.2
|
63.7
|
0.019
|
STEMI | 46.1 | 47.7 | 0.313 | |
NSTEMI | 65.0 | 65.2 | 0.834 | |
stable CAD | 66.3 | 67.5 | 0.169 | |
Clopidogrel (%) | Total | 88.5 | 88.4 | 0.880 |
STEMI | 91.7 | 92.1 | 0.678 | |
NSTEMI | 90.8 | 90.6 | 0.832 | |
stable CAD | 86.0 | 86.3 | 0.647 | |
GPIIb/IIIa-Inhibitor (%) | Total | 21.8 | 21.5 | 0.645 |
STEMI | 57.4 | 59.7 | 0.085 | |
NSTEMI | 26.1 | 27.3 | 0.171 | |
stable CAD
|
7.1
|
8.3
|
0.002
| |
Procedure related mortality and MACCE | ||||
Mortality (intrahospital) (%) |
Total
|
2.8
|
2.2
|
0.006
|
STEMI | 9.4 | 8.4 | 0.251 | |
NSTEMI | 2.9 | 2.7 | 0.686 | |
stable CAD
|
0.6
|
0.3
|
0.013
| |
MACCE (Death, MI, Stroke/TIA) (%) |
Total
|
3.3
|
2.8
|
0.023
|
STEMI | 10.2 | 9.3 | 0.399 | |
NSTEMI | 3.5 | 3.2 | 0.452 | |
stable CAD
|
1.2
|
0.8
|
0.031
| |
Non-MACCE access site related complications (i.e. bleeding) (%) |
Total
|
3.6
|
1.8
|
<0.001
|
STEMI
|
4.2
|
1.3
|
<0.001
| |
NSTEMI
|
4.0
|
2.1
|
<0.001
| |
stable CAD
|
3.3
|
1.8
|
<0.001
|