ISSN 1671-5411 CN 11-5329/R

Dear Colleagues,

Journal of Geriatric Cardiology (J Geriatr Cardiol, JGC) will launch a new website and adopt ScholarOne ManuscriptsTM system to manage the submission and peer review process from November 1, 2020. To review and check the status of your manuscripts submitted before November 2020, please visit...


Volume 17 Issue 11
Dec.  2020
Turn off MathJax
Article Contents
Myunhee Lee, Dae-Won Kim, Mahn-Won Park, Kyusup Lee, Kiyuk Chang, Wook Sung Chung, Tae Hoon Ahn, Myung Ho Jeong, Seung-Woon Rha, Hyo-Soo Kim, Hyeon Cheol Gwon, In Whan Seong, Kyung Kuk Hwang, Shung Chull Chae, Kwon-Bae Kim, Young Jo Kim, Kwang Soo Cha, Seok Kyu Oh, Jei Keon Chae, Ji-Hoon Jung, on behalf of KAMIR-NIH registry investigators. Gender differences in clinical outcomes of acute myocardial infarction undergoing percutaneous coronary intervention: insights from the KAMIR-NIH Registry. J Geriatr Cardiol 2020; 17(11): 680-693. doi: 10.11909/j.issn.1671-5411.2020.11.006
Citation: Myunhee Lee, Dae-Won Kim, Mahn-Won Park, Kyusup Lee, Kiyuk Chang, Wook Sung Chung, Tae Hoon Ahn, Myung Ho Jeong, Seung-Woon Rha, Hyo-Soo Kim, Hyeon Cheol Gwon, In Whan Seong, Kyung Kuk Hwang, Shung Chull Chae, Kwon-Bae Kim, Young Jo Kim, Kwang Soo Cha, Seok Kyu Oh, Jei Keon Chae, Ji-Hoon Jung, on behalf of KAMIR-NIH registry investigators. Gender differences in clinical outcomes of acute myocardial infarction undergoing percutaneous coronary intervention: insights from the KAMIR-NIH Registry. J Geriatr Cardiol 2020; 17(11): 680-693. doi: 10.11909/j.issn.1671-5411.2020.11.006

Gender differences in clinical outcomes of acute myocardial infarction undergoing percutaneous coronary intervention: insights from the KAMIR-NIH Registry

doi: 10.11909/j.issn.1671-5411.2020.11.006
More Information
  • Corresponding author:

    Dae-Won Kim, E-mail:

  • Received Date: 2020-08-25
  • Accepted Date: 2020-11-27
  • Rev Recd Date: 2020-11-08
  • Available Online: 2020-11-28
  • Publish Date: 2020-11-28
  •  Background There are numerous but conflicting data regarding gender differences in outcomes following percutaneous coronary intervention (PCI). Furthermore, gender differences in clinical outcomes with acute myocardial infarction (AMI) following PCI in Asian population remain uncertain because of the under-representation of Asian in previous trials. Methods A total of 13, 104 AMI patients from Korea Acute Myocardial Infarction Registry-National Institute of Health (KAMIR-NIH) between November 2011 and December 2015 were classified into male (n = 8021, 75.9%) and female (n = 2547, 24.1%). We compared the demographic, clinical and angiographic characteristics, 30-days and 1-year major adverse cardiac and cerebrovascular events (MACCE) in women with those in men after AMI by using propensity score (PS) matching. Results Compared with men, women were older, had more comorbidities and more often presented with non-ST segment elevation myocardial infarction (NSTEMI) and reduced left ventricular systolic function. Over the median follow-up of 363 days, gender differences in both 30-days and 1-year MACCE as well as thrombolysis in myocardial infarction minor bleeding risk were not observed in the PS matched population (30-days MACCE: 5.3% vs. 4.7%, log-rank P = 0.494, HR = 1.126, 95% CI: 0.800-1.585; 1-year MACCE: 9.3% vs. 9.0%, log-rank P = 0.803, HR = 1.032, 95% CI: 0.802-1.328; TIMI minor bleeding: 4.9% vs. 3.9%, log-rank P= 0.215, HR = 1.255, 95% CI: 0.869-1.814). Conclusions Among Korean AMI population undergoing contemporary PCI, women, as compared with men, had different clinical and angiographic characteristics but showed similar 30-days and 1-year clinical outcomes. The risk of bleeding after PCI was comparable between men and women during one-year follow up.
  • loading
  • [1]
    Mozaffarian D, Benjamin EJ, Go AS, et al. Heart disease and stroke statistics--2015 update: a report from the American Heart Association. Circulation 2015; 131: e29-322.
    Lee SW, Kim HC, Lee HS, Suh I. Thirty-year trends in mortality from cardiovascular diseases in korea. Korean Circ J 2015; 45: 202-209. doi: 10.4070/kcj.2015.45.3.202
    Malenka DJ, O'Connor GT, Quinton H, et al. Differences in outcomes between women and men associated with percutaneous transluminal coronary angioplasty. A regional prospective study of 13, 061 procedures. Northern New England Cardiovascular Disease Study Group. Circulation 1996; 94: Ⅱ99-Ⅱ104.
    Cowley MJ, Mullin SM, Kelsey SF, et al. Sex differences in early and long-term results of coronary angioplasty in the NHLBI PTCA Registry. Circulation 1985; 71: 90-97. doi: 10.1161/01.CIR.71.1.90
    Kelsey SF, James M, Holubkov AL, et al. Results of percutaneous transluminal coronary angioplasty in women. 1985- 1986 National Heart, Lung, and Blood Institute's Coronary Angioplasty Registry. Circulation 1993; 87: 720-727. doi: 10.1161/01.CIR.87.3.720
    Milcent C, Dormont B, Durand-Zaleski I, Steg PG. Gender differences in hospital mortality and use of percutaneous coronary intervention in acute myocardial infarction: microsimulation analysis of the 1999 nationwide French hospitals database. Circulation 2007; 115: 833-839. doi: 10.1161/CIRCULATIONAHA.106.664979
    Venetsanos D, Sederholm Lawesson S, Alfredsson J, et al. Association between gender and short-term outcome in patients with ST elevation myocardial infraction participating in the international, prospective, randomised Administration of Ticagrelor in the catheterisation Laboratory or in the Ambulance for New ST elevation myocardial Infarction to open the Coronary artery (ATLANTIC) trial: a prespecified analysis. BMJ Open 2017; 7: e015241. doi: 10.1136/bmjopen-2016-015241
    Peterson ED, Lansky AJ, Kramer J, et al. Effect of gender on the outcomes of contemporary percutaneous coronary intervention. Am J Cardiol 2001; 88: 359-364. doi: 10.1016/S0002-9149(01)01679-4
    Jacobs AK, Johnston JM, Haviland A, et al. Improved outcomes for women undergoing contemporary percutaneous coronary intervention: a report from the National Heart, Lung, and Blood Institute Dynamic registry. J Am Coll Cardiol 2002; 39: 1608-1614. doi: 10.1016/S0735-1097(02)01835-1
    Iyanoye A, Moreyra AE, Swerdel JN, et al. Gender disparity in the use of drug-eluting stents during percutaneous coronary intervention for acute myocardial infarction. Catheter Cardiovasc Interv 2015; 86: 221-228. doi: 10.1002/ccd.25837
    Bell MR, Holmes DR, Jr., Berger PB, et al. The changing in-hospital mortality of women undergoing percutaneous transluminal coronary angioplasty. JAMA 1993; 269: 2091-2095. doi: 10.1001/jama.1993.03500160061032
    Arnold AM, Mick MJ, Piedmonte MR, Simpfendorfer C. Gender differences for coronary angioplasty. Am J Cardiol 1994; 74: 18-21. doi: 10.1016/0002-9149(94)90484-7
    Singh M, Rihal CS, Gersh BJ, et al. Mortality differences between men and women after percutaneous coronary interventions. A 25-year, single-center experience. J Am Coll Cardiol 2008; 51: 2313-2320. doi: 10.1016/j.jacc.2008.01.066
    Park JS, Kim YJ, Shin DG, et al. Gender differences in clinical features and in-hospital outcomes in ST-segment elevation acute myocardial infarction: from the Korean Acute Myocardial Infarction Registry (KAMIR) study. Clin Cardiol 2010; 33: E1-E6.
    Mrdovic I, Savic L, Asanin M, et al. Sex-related analysis of short- and long-term clinical outcomes and bleeding among patients treated with primary percutaneous coronary intervention: an evaluation of the RISK-PCI data. Can J Cardiol 2013; 29: 1097-1103. doi: 10.1016/j.cjca.2012.11.013
    Vasiljevic-Pokrajcic Z, Mickovski N, Davidovic G, et al. Sex and age differences and outcomes in acute coronary syndromes. Int J Cardiol 2016; 217 Suppl: S27-S31.
    Levine GN, Bates ER, Blankenship JC, et al. 2011 ACCF/ AHA/SCAI Guideline for Percutaneous Coronary Intervention. A report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines and the Society for Cardiovascular Angiography and Interventions. J Am Coll Cardiol 2011; 58: e44-e122. doi: 10.1016/j.jacc.2011.08.007
    Thygesen K, Alpert JS, Jaffe AS, et al. Fourth universal definition of myocardial infarction (2018). Eur Heart J 2019; 40: 237-269. doi: 10.1093/eurheartj/ehy462
    Brosius FC, Hostetter TH, Kelepouris E, et al. Detection of chronic kidney disease in patients with or at increased risk of cardiovascular disease. Circulation 2006; 114: 1083-1087. doi: 10.1161/CIRCULATIONAHA.106.177321
    Cutlip DE, Windecker S, Mehran R, et al. Clinical end points in coronary stent trials: a case for standardized definitions. Circulation 2007; 115: 2344-2351. doi: 10.1161/CIRCULATIONAHA.106.685313
    Wiviott SD, Antman EM, Gibson CM, et al. Evaluation of prasugrel compared with clopidogrel in patients with acute coronary syndromes: design and rationale for the TRial to assess Improvement in Therapeutic Outcomes by optimizing platelet InhibitioN with prasugrel Thrombolysis In Myocardial Infarction 38 (TRITON-TIMI 38). Am Heart J 2006; 152: 627-635. doi: 10.1016/j.ahj.2006.04.012
    Laskey WK, Yancy CW, Maisel WH. Thrombosis in coronary drug-eluting stents: report from the meeting of the circulatory system medical devices advisory panel of the food and drug administration center for devices and radiologic health, december 7-8, 2006. Circulation 2007; 115: 2352-2357. doi: 10.1161/CIRCULATIONAHA.107.688416
    Kang SH, Suh JW, Yoon CH, et al. Sex differences in management and mortality of patients with ST-elevation myocardial infarction (from the Korean Acute Myocardial Infarction National Registry). Am J Cardiol 2012; 109: 787-793. doi: 10.1016/j.amjcard.2011.11.006
    Shih JY, Chen ZC, Chang HY, et al. Risks of age and sex on clinical outcomes post myocardial infarction. Int J Cardiol Heart Vasc 2019; 23: 100350.
    Kunadian V, Qiu W, Lagerqvist B, et al. Gender Differences in Outcomes and Predictors of All-Cause Mortality After Percutaneous Coronary Intervention (Data from United Kingdom and Sweden). Am J Cardiol 2017; 119: 210-216. doi: 10.1016/j.amjcard.2016.09.052
    Shaw LJ, Shaw RE, Merz CN, et al. Impact of ethnicity and gender differences on angiographic coronary artery disease prevalence and in-hospital mortality in the American College of Cardiology-National Cardiovascular Data Registry. Circulation 2008; 117: 1787-1801. doi: 10.1161/CIRCULATIONAHA.107.726562
    Jneid H, Fonarow GC, Cannon CP, et al. Sex differences in medical care and early death after acute myocardial infarction. Circulation 2008; 118: 2803-2810. doi: 10.1161/CIRCULATIONAHA.108.789800
    Anand SS, Xie CC, Mehta S, et al. Differences in the management and prognosis of women and men who suffer from acute coronary syndromes. J Am Coll Cardiol 2005; 46: 1845-1851. doi: 10.1016/j.jacc.2005.05.091
    Bandyopadhyay D, Chakraborty S, Amgai B, et al. Acute myocardial infarction in the young-National Trend Analysis with gender-based difference in outcomes. Int J Cardiol 2020; 301: 21-28. doi: 10.1016/j.ijcard.2019.11.096
    Stehli J, Martin C, Brennan A, et al. Sex Differences Persist in Time to Presentation, Revascularization, and Mortality in Myocardial Infarction Treated With Percutaneous Coronary Intervention. J Am Heart Assoc 2019; 8: e012161.
    Naito R, Miyauchi K, Konishi H, et al. Gender difference in long-term clinical outcomes following percutaneous coronary intervention during 1984-2008. Atherosclerosis 2016; 247: 105-110. doi: 10.1016/j.atherosclerosis.2015.10.088
    Hess CN, McCoy LA, Duggirala HJ, et al. Sex-based differences in outcomes after percutaneous coronary intervention for acute myocardial infarction: a report from TRANSLATE- ACS. J Am Heart Assoc 2014; 3: e000523.
    Mahajan AM, Claessen BE, Chandrasekhar J, et al. Outcomes by Gender and Ethnicity After Percutaneous Coronary Intervention. Am J Cardiol 2019; 123: 1941-1948. doi: 10.1016/j.amjcard.2019.03.019
    Gasevic D, Khan NA, Qian H, et al. Outcomes following percutaneous coronary intervention and coronary artery bypass grafting surgery in Chinese, South Asian and White patients with acute myocardial infarction: administrative data analysis. BMC Cardiovasc Disord 2013; 13: 121. doi: 10.1186/1471-2261-13-121
    Krishnamurthy A, Keeble C, Burton-Wood N, et al. Clinical outcomes following primary percutaneous coronary intervention for ST-elevation myocardial infarction according to sex and race. Eur Heart J Acute Cardiovasc Care 2019; 8: 264-272. doi: 10.1177/2048872617735803
    Tang XF, Song Y, Xu JJ, et al. Effect of sex difference in clinical presentation (stable coronary artery disease vs. unstable angina pectoris or non-ST-elevation myocardial infarction vs. ST-elevation myocardial infarction) on 2-year outcomes in patients undergoing percutaneous coronary intervention. J Interv Cardiol 2018; 31: 5-14. doi: 10.1111/joic.12451
    Acharjee S, Teo KK, Jacobs AK, et al. Optimal medical therapy with or without percutaneous coronary intervention in women with stable coronary disease: A pre-specified subset analysis of the Clinical Outcomes Utilizing Revascularization and Aggressive druG Evaluation (COURAGE) trial. Am Heart J 2016; 173: 108-117. doi: 10.1016/j.ahj.2015.07.020
    Kanic V, Suran D, Krajnc I, Kompara G. ST-elevation myocardial infarction in a real world population - An observational retrospective study with a sex perspective. Eur J Intern Med 2019; 66: 81-84. doi: 10.1016/j.ejim.2019.06.004
    Shehab A, Bhagavathula AS, Alhabib KF, et al. Age-related sex differences in clinical presentation, management, and outcomes in st-segment-elevation myocardial infarction: pooled analysis of 15 532 patients from 7 arabian gulf registries. J Am Heart Assoc 2020; 9: e013880.
    Cenko E, Yoon J, Kedev S, et al. Sex differences in outcomes after STEMI: effect modification by treatment strategy and age. JAMA Intern Med 2018; 178: 632-639. doi: 10.1001/jamainternmed.2018.0514
  • 加载中


    通讯作者: 陈斌,
    • 1. 

      沈阳化工大学材料科学与工程学院 沈阳 110142

    1. 本站搜索
    2. 百度学术搜索
    3. 万方数据库搜索
    4. CNKI搜索

    Figures(5)  / Tables(4)

    Article Metrics

    Article views (154) PDF downloads(14) Cited by()
    Proportional views


    DownLoad:  Full-Size Img  PowerPoint