DOCUMENTATION OF DECLINE IN MORBIDITY IN WOMEN UNDERGOING CORONARY ANGIOPLASTY (A REPORT FROM THE 1993-94 NHLBI PERCUTANEOUS TRANSLUMINAL CORONARY ANGIOPLASTY REGISTRY)

To determine whether there has been an improvement in the relatively u nfavorable outcome of percutaneaus transluminal coronary angioplasty ( PTCA) in women, the 1993 to 1994 National Heart, Lung, and Blood Insti tute Percutaneous Transluminal Coronary Angioplasty Registry collected data from 12 clinical centers that participated in the earlier regist ries. We compared 274 consecutive women in 1993 to 1994 with 545 conse cutive women in 1985 to 1986 undergoing PTCA. Women in the 1993 to 199 4 registry were older (64.3 vs 61.0 years, p <0.001) with more diabete s mellitus (34.3% vs 19.9%, p <0.001), congestive heart failure (13.7% vs 8.6%, p <0.05), and comorbid disease (19.5% vs 9.3%, p <0.001). Le ft ventricular function and multivessel coronary artery disease were s imilar between groups. Angiographic success (90.9% vs 85.1%, p <0.05) and clinical success (89.4% vs 79.4%, p <0.001) were higher in women u ndergoing PTCA in 1993 to 1994 than in 1985 to 1986. Whereas there wet s no difference in in-hospital mortality (1.5% vs 2.6%), the incidence of nonfatal myocardial infarction (1.8% vs 4.6%, p <0.05), emergency coronary artery bypass graft surgery (1.8% vs 4.6%, p <0.05), and the combined end points of death, myocardial infarction, and emergency cor onary artery bypass grafting (4.4% vs 9.7%, p <0.01) were lower in wom en in 1993 to 1994 than in women in 1985 to 1986, respectively. Multiv ariate analysis revealed an odds ratio of 0.36 (95% confidence interva l 0.18 to 0.72) for major complications and of 2.34 (95% confidence in terval, 1.49 to 3.69) for clinical success in the 1993 to 1994 versus 1985 to 1986 registry. Therefore, despite a higher risk profile, women undergoing PTCA in 1993 to 1994 have a higher clinical success and lo wer major complication rate than women treated with PTCA in 1985 to 19 86. (C) 1997 by Excerpta Medica, Inc.