Nowakowska-Arendt Agnieszka, Grabczewska Zofia, Koziński Marek, Sukiennik Adam, Swiatkiewicz Iwona, Grześk Grzegorz, Radomski Marek, Bogdan Maria, Kochman Wacław, Kubica Jacek
Department of Cardiology and Internal Diseases, A Jurasza University Hospital, Bydgoszcz, Poland.
Kardiol Pol. 2008 Jun;66(6):632-9; discussion 640-1.
Many observational and randomised studies have suggested that women are referred for invasive diagnostics and treatment of coronary artery disease (CAD) less frequently than men, and the effects of percutaneous coronary intervention (PCI) among women are worse than in men.
To compare direct results of PCI in men and women.
The study was a retrospective assessment of case records of one thousand consecutive patients treated with PCI because of acute myocardial infarction (AMI) (344 patients), unstable angina (UA) (164 patients) and stable angina (SA) (492 patients). We examined the effects of demographic, angiographic and clinical variables on the duration of hospitalisation and in-hospital mortality separately in men and in women.
Women constituted 30.7% of patients treated with PCI because of AMI, 39.6% of those with UA and just 25.8% of those with SA. Women were significantly older than men, had a higher BMI, and more often suffered from hypertension and diabetes. The duration of hospitalisation was the same in men and women if the reason for PCI was SA or UA, however, in case of AMI women were hospitalised significantly longer than men. In the univariate analysis gender had no influence on in-hospital mortality regardless of the reason for PCI treatment. Among the variables subjected to multivariate analysis female gender, age, BMI, diabetes, hypercholesterolaemia, indication for PCI, final TIMI flow in the target vessel and cardiogenic shock as a complication of AMI were shown to affect mortality. Significant effects on in-hospital mortality for women were exhibited only by cardiogenic shock. Among men, indication for PCI, age, diabetes and final TIMI flow in the target vessel also had a significant influence on in-hospital mortality.
Stable angina is a reason for performing PCI more rarely in women than in men. Women with CAD are older than men and have more risk factors. The in-hospital mortality among patients treated with PCI because of SA is independent of gender. Cardiogenic shock appeared to be the only factor that influences in-hospital mortality in women. In the case of men such an influence is also observed for indication for PCI (AMI, UA or SA), diabetes and final TIMI flow in the target vessel.
许多观察性研究和随机研究表明，与男性相比，女性接受冠状动脉疾病（CAD）侵入性诊断和治疗的频率较低，且女性经皮冠状动脉介入治疗（PCI）的效果比男性差。
比较男性和女性PCI的直接结果。
本研究是一项回顾性评估，对因急性心肌梗死（AMI）（344例患者）、不稳定型心绞痛（UA）（164例患者）和稳定型心绞痛（SA）（492例患者）接受PCI治疗的连续1000例患者的病例记录进行分析。我们分别研究了人口统计学、血管造影和临床变量对男性和女性住院时间和院内死亡率的影响。
因AMI接受PCI治疗的患者中女性占30.7%，因UA接受治疗的患者中女性占39.6%，而因SA接受治疗的患者中女性仅占25.8%。女性比男性年龄显著更大，体重指数更高，且更常患有高血压和糖尿病。如果PCI的原因是SA或UA，男性和女性的住院时间相同，然而，在AMI的情况下，女性住院时间显著长于男性。在单因素分析中，无论PCI治疗的原因如何，性别对院内死亡率均无影响。在多因素分析的变量中，女性性别、年龄、体重指数、糖尿病、高胆固醇血症、PCI指征、靶血管最终心肌梗死溶栓（TIMI）血流以及作为AMI并发症的心源性休克均显示会影响死亡率。仅心源性休克对女性院内死亡率有显著影响。在男性中，PCI指征、年龄、糖尿病和靶血管最终TIMI血流对院内死亡率也有显著影响。
与男性相比，稳定型心绞痛是女性较少进行PCI的原因。患有CAD的女性比男性年龄更大且有更多危险因素。因SA接受PCI治疗的患者院内死亡率与性别无关。心源性休克似乎是影响女性院内死亡率的唯一因素。在男性中，PCI指征（AMI、UA或SA）、糖尿病和靶血管最终TIMI血流也观察到有此类影响。
