관상동맥 중재시술 이후 성별에 따른 임상적인 예후 비교

Abstract

Objectives: We aimed to investigate sex-related impacts on clinical outcomes in patients undergoing percutaneous coronary intervention (PCI). Background: Sex-related differences in patients with cardiovascular disease had been cited as reasons for worse prognosis in women. Under concurrent PCI, the impacts of sex on clinical outcomes have not been fully clarified yet. Methods: We analyzed 90,305 patients (29.0% of women) with the first episode of coronary artery disease who underwent PCI from the Korean National Health Insurance claims database between July 2013 and June 2017. Results: Women were significantly older than men (71.5±10.5 versus 61.8±11.7 years, p<0.001). And the Charlson comorbidity index was significantly higher in women than men (1.59±1.46 versus 1.12±1.35, p<0.001). The study population had a median follow-up of 2.2 years (interquartile range, 1.2–3.3). In the propensity-score matched angina population (15,104 pairs), the in-hospital mortality of women was not different from men (odds ratio, 0.87; 95% confidence interval: 0.71–1.08, p=0.202). However, the post-discharge mortality of women was significantly lower (hazard ratio, 0.74; 95% confidence interval: 0.69-0.80, p<0.001) than that of men. In the propensity-score matched AMI population (8,775 pairs), the in-hospital mortality of women was significantly higher than that of men (odds ratio, 1.19; 95% confidence interval: 1.05-1.34, p=0.006). Meanwhile, there was no difference in mortality after discharge (hazard ratio, 0.98; 95% confidence interval: 0.91-1.06, p=0.605). Conclusion: The post-discharge mortality of women was not higher than men under the contemporary PCI treatment. Altered sex-related impacts on clinical outcomes might be attributed to improved medical and procedural strategies.