Sex-based Differences in Percutaneous Coronary Intervention Outcomes in Patients with Ischaemic Heart Disease.

In high-income countries, ischaemic heart disease is the leading cause of death in women and men, accounting for more than 20% of deaths in both sexes. However, women are less likely to receive guideline-recommended percutaneous coronary intervention (PCI) than men. Women undergoing PCI have poorer unadjusted outcomes because they are older and have greater comorbidity than men, but uncertainty remains whether sex affects outcome after these differences in clinical characteristics are considered. In this paper, we review recent published evidence comparing outcomes between men and women undergoing PCI. We focus on the sex differences in PCI outcomes in different scenarios: acute coronary syndromes, stable angina and complex lesions, including the approach of left main coronary artery. We also review how gender is considered in recent guidelines and offer a common clinical scenario to illustrate the contemporary management strategies an interventional cardiologist should consider when performing PCI on a female patient.

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Copyright © 2023, Radcliffe Cardiology.

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Disclosures: AS is on the European Cardiology Review editorial board; this did not influence peer review. AC reports consultant/speaker fees from Abiomed, Abbott Vascular, Boston Scientific and Edwards. CW reports an institutional research payment from Bristol-Myers Squibb. RM reports institutional research payments from Abbott, Abiomed, Alleviant Medical, AM-Pharma, Arena, AstraZeneca, BAIM, Beth Israel Deaconess, Biosensors, Biotronik, Boston Scientific, Bristol-Myers Squibb, CardiaWave, CeloNova, CERC, Chiesi, Concept Medical, CSL Behring, Cytosorbents, DSI, Duke University, Element Science, Faraday, Humacyte, Idorsia, Insel Gruppe AG, Magenta, Medtronic, Novartis, OrbusNeich, Philips, RenalPro and Vivasure, Zoll; personal fees from Cine-Med Research and WebMD; consulting fees paid to the institution from Abbott, Janssen, Medtronic and Novartis; equity <1% in Applied Therapeutics, Elixir Medical, STEL and CONTROLRAD (spouse); being on scientific advisory boards for the AMA, ACC (BOT member), SCAI (Women in Innovations committee member); and being a JAMA Associate Editor and Faculty CRF (no fee). All other authors have no conflicts of interest to declare.