A53 JACC April 1, 2014 Volume 63, Issue 12 Acute Coronary Syndromes MIND THE GENDER GAP: POST PERCUTANEOUS CORONARY INTERVENTION COMPLICATIONS FOLLOWING ACUTE MYOCARDIAL INFARCTION, A CONTEMPORARY ANALYSIS Poster Contributions Hall C Saturday, March 29, 2014, 10:00 a.m.-10:45 a.m. Session Title: Acute Coronary Syndromes: NSTEMI Abstract Category: 1. Acute Coronary Syndromes: Clinical Presentation Number: 1117-230 Authors: Megha Agarwal, Melvie Kim, Ashwini Erande, Pranav Patel, Alpesh Amin, Shaista Malik, University of California, Irvine, Orange, CA, USA Background: Data suggest women have higher rates of vascular complications (VCs) and mortality than men following percutaneous coronary intervention (PCI) during hospitalization for an acute myocardial infarction (AMI). Which risk factors (RFs) make women susceptible and if gender remains predictive of VCs in a large, contemporary, nationally representative cohort is unknown. Methods: We studied 222,660 consecutive cases of men and women from the National Inpatient Sample registry with AMI who underwent PCI in 2009. The relationship between gender, post-PCI VC and 30-day in-hospital all-cause mortality was compared. We then examined the association between RFs, VC and mortality among men and women. Results: 71,031 women and 151,630 men underwent PCI for AMI. 4,565 (6.4%) women and 5,229 (3.5%) men had a VC. Of those with VC, 331 women (7.3%) and 200 men (3.8%) died. After covariate adjustments women were more likely to have a VC (OR=1.79; 95% CI 1.72-1.87) and more likely to die within 30 days (OR=1.61; 95% CI 1.31-1.95) compared to men. Peripheral vascular disease (PVD) was associated with increased VC and mortality while hyperlipidemia had the opposite relationship. Obesity was associated with increased VC but reduced mortality while diabetes had the reverse association (Table). Conclusions: Female gender is a signiﬁcant independent RF for VC and mortality post-PCI in AMI. To close this gender gap, future studies are needed to understand the role of PVD, hyperlipidemia and the reverse diabetes paradox.

MIND THE GENDER GAP: POST PERCUTANEOUS CORONARY INTERVENTION COMPLICATIONS FOLLOWING ACUTE MYOCARDIAL INFARCTION, A CONTEMPORARY ANALYSIS

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Page 1: MIND THE GENDER GAP: POST PERCUTANEOUS CORONARY INTERVENTION COMPLICATIONS FOLLOWING ACUTE MYOCARDIAL INFARCTION, A CONTEMPORARY ANALYSIS

A53JACC April 1, 2014

Volume 63, Issue 12

Acute Coronary Syndromes

mind the gender gap: poSt perCutaneouS Coronary intervention CompliCationS FolloWing aCute myoCardial inFarCtion, a Contemporary analySiS

Poster ContributionsHall CSaturday, March 29, 2014, 10:00 a.m.-10:45 a.m.

Session Title: Acute Coronary Syndromes: NSTEMIAbstract Category: 1. Acute Coronary Syndromes: ClinicalPresentation Number: 1117-230

Authors: Megha Agarwal, Melvie Kim, Ashwini Erande, Pranav Patel, Alpesh Amin, Shaista Malik, University of California, Irvine, Orange, CA, USA

background: Data suggest women have higher rates of vascular complications (VCs) and mortality than men following percutaneous coronary intervention (PCI) during hospitalization for an acute myocardial infarction (AMI). Which risk factors (RFs) make women susceptible and if gender remains predictive of VCs in a large, contemporary, nationally representative cohort is unknown.

methods: We studied 222,660 consecutive cases of men and women from the National Inpatient Sample registry with AMI who underwent PCI in 2009. The relationship between gender, post-PCI VC and 30-day in-hospital all-cause mortality was compared. We then examined the association between RFs, VC and mortality among men and women.

results: 71,031 women and 151,630 men underwent PCI for AMI. 4,565 (6.4%) women and 5,229 (3.5%) men had a VC. Of those with VC, 331 women (7.3%) and 200 men (3.8%) died. After covariate adjustments women were more likely to have a VC (OR=1.79; 95% CI 1.72-1.87) and more likely to die within 30 days (OR=1.61; 95% CI 1.31-1.95) compared to men. Peripheral vascular disease (PVD) was associated with increased VC and mortality while hyperlipidemia had the opposite relationship. Obesity was associated with increased VC but reduced mortality while diabetes had the reverse association (Table).

Conclusions: Female gender is a significant independent RF for VC and mortality post-PCI in AMI. To close this gender gap, future studies are needed to understand the role of PVD, hyperlipidemia and the reverse diabetes paradox.