BACKGROUND: This study was performed to assess the influence of sex on drug therapy and long-term outcomes in acute coronary syndrome (ACS) patients who underwent percutaneous coronary intervention (PCI). METHODS: This is a retrospective cohort study of ACS patients who underwent PCI [women (n=8,884) and men (n=23,937)] between January 1, 2006, and December 31, 2007, with at least a 1-year follow-up, based on the National Health Insurance Research Database in Taiwan. Propensity score was used to identify a 1:1 matched cohort (n=17,768) for multivariable adjustment. The influence of sex on drug therapy and outcomes was examined by multivariate logistic regression and multivariable Cox proportional hazards regression. RESULTS: Female patients had an 18% and 12% lower likelihood of receiving aspirin (adjusted odds ratio [OR(adj)]=0.82, 95% confidence interval [CI]=0.77-0.88) and clopidogrel (OR(adj)=0.88, 95% CI=0.81-0.95), respectively, than male patients but had a 17% and 22% higher likelihood of receiving beta-blockers (OR(adj)=1.17, 95% CI=1.10-1.24) and statins (OR(adj)=1.22, 95% CI=1.14-1.29), respectively, than male patients in the matched cohort. The adjusted hazard ratio (HR(adj)) of rehospitalization for revascularization in women was 0.84 (95% CI=0.79-0.90) compared with men after at least a 1-year follow-up in the matched cohort. CONCLUSIONS: Female patients with ACS who underwent PCI were less likely to receive aspirin and clopidogrel but were more likely to receive beta-blockers and statins than male patients. Male sex was associated with a higher risk of rehospitalization for revascularization than female sex.
BACKGROUND: This study was performed to assess the influence of sex on drug therapy and long-term outcomes in acute coronary syndrome (ACS) patients who underwent percutaneous coronary intervention (PCI). METHODS: This is a retrospective cohort study of ACS patients who underwent PCI [women (n=8,884) and men (n=23,937)] between January 1, 2006, and December 31, 2007, with at least a 1-year follow-up, based on the National Health Insurance Research Database in Taiwan. Propensity score was used to identify a 1:1 matched cohort (n=17,768) for multivariable adjustment. The influence of sex on drug therapy and outcomes was examined by multivariate logistic regression and multivariable Cox proportional hazards regression. RESULTS: Female patients had an 18% and 12% lower likelihood of receiving aspirin (adjusted odds ratio [OR(adj)]=0.82, 95% confidence interval [CI]=0.77-0.88) and clopidogrel (OR(adj)=0.88, 95% CI=0.81-0.95), respectively, than male patients but had a 17% and 22% higher likelihood of receiving beta-blockers (OR(adj)=1.17, 95% CI=1.10-1.24) and statins (OR(adj)=1.22, 95% CI=1.14-1.29), respectively, than male patients in the matched cohort. The adjusted hazard ratio (HR(adj)) of rehospitalization for revascularization in women was 0.84 (95% CI=0.79-0.90) compared with men after at least a 1-year follow-up in the matched cohort. CONCLUSIONS: Female patients with ACS who underwent PCI were less likely to receive aspirin and clopidogrel but were more likely to receive beta-blockers and statins than male patients. Male sex was associated with a higher risk of rehospitalization for revascularization than female sex.
Authors: Frederick G Kushner; Mary Hand; Sidney C Smith; Spencer B King; Jeffrey L Anderson; Elliott M Antman; Steven R Bailey; Eric R Bates; James C Blankenship; Donald E Casey; Lee A Green; Judith S Hochman; Alice K Jacobs; Harlan M Krumholz; Douglass A Morrison; Joseph P Ornato; David L Pearle; Eric D Peterson; Michael A Sloan; Patrick L Whitlow; David O Williams Journal: Circulation Date: 2009-11-18 Impact factor: 29.690
Authors: Jeffrey S Berger; Deepak L Bhatt; Christopher P Cannon; Zhengming Chen; Lixin Jiang; James B Jones; Shamir R Mehta; Marc S Sabatine; Steven R Steinhubl; Eric J Topol; Peter B Berger Journal: J Am Coll Cardiol Date: 2009-11-17 Impact factor: 24.094
Authors: Yoshinobu Onuma; Neville Kukreja; Joost Daemen; Hector M Garcia-Garcia; Nieves Gonzalo; Jin Ming Cheng; Piet Hein van Twisk; Ron van Domburg; Patrick W Serruys Journal: JACC Cardiovasc Interv Date: 2009-07 Impact factor: 11.195
Authors: Nausheen Akhter; Sarah Milford-Beland; Matthew T Roe; Robert N Piana; John Kao; Adhir Shroff Journal: Am Heart J Date: 2009-01 Impact factor: 4.749