Jl. Vacek et al., SEX-RELATED DIFFERENCES IN PATIENTS UNDERGOING DIRECT ANGIOPLASTY FORACUTE MYOCARDIAL-INFARCTION, The American heart journal, 126(3), 1993, pp. 521-525
Important sex-related differences have been recognized in several coro
nary artery disease presentation and treatment subsets. Little data ex
ist describing the relative findings and outcome in women versus men w
ho received direct percutaneous transluminal coronary angioplasty for
acute myocardial infarction. We studied 670 such patients of whom 464
(69%) were men and 206 were women. The women were significantly older
(67 +/- 11 years vs 61 +/- 11, p < 0.001) but had undergone less prior
coronary artery bypass graft surgery (6% vs 12%, p = 0.02), whereas p
rior myocardial infarction (17% women vs 22% men) and coronary artery
disease distribution were not significantly different. Forty-one perce
nt of women and 43% of men had single-vessel disease (p = NS). Both wo
men and men had 1.5 lesions/patient dilated acutely, with similar succ
ess rates (95% women, 91% men; p = 0.08). Mean ejection fractions were
similar (48% in both groups), and a similar percentage in each group
had an ejection fraction <30% (10% women vs 13% men). Over a mean foll
ow-up period of 86 weeks, the need for repeat catheterization was freq
uent and was similar in both groups (44% women, 47% men; p = NS), wher
eas documented restenosis was less common in women (20% vs 28% of pati
ents, p < 0.05). The need for coronary artery bypass grafting was simi
lar (15% women, 17% men; p = NS), as was the need for repeat percutane
ous transluminal coronary angioplasty in the infarct vessel (14% women
, 18% men; p = NS) and overall mortality (7% women, 9% men; p = NS). W
e concluded that other than older age, the clinical features of the wo
men initially seen for direct percutaneous transluminal coronary angio
plasty for acute myocardial infarction are very similar to those of me
n. In spite of this age difference, percutaneous transluminal coronary
angioplasty success and outcomes are also very similar, other than a
29% lower incidence of documented restenosis in women.