BACKGROUND Studies examining sex-related outcomes following percutaneous coronary intervention (PCI) have reported conflicting results. OBJECTIVES The purpose of this study was to examine the sex-related risk of 5-year cardiovascular outcomes after PCI. METHODS The authors pooled patient-level data from 21 randomized PCI trials and assessed the association between sex and major adverse cardiac events (MACE) (cardiac death, myocardial infarction [MI], or ischemia-driven target lesion revascularization [ID-TLR]) as well as its individual components at 5 years. RESULTS Among 32,877 patients, 9,141 (27.8%) were women. Women were older and had higher body mass index, more frequent hypertension and diabetes, and less frequent history of surgical or percutaneous revascularization compared with men. By angiographic core laboratory analysis, lesions in women had smaller reference vessel diameter and shorter lesion length. At 5 years, women had a higher unadjusted rate of MACE (18.9% vs. 17.7%; p = 0.003), all-cause death (10.4% vs. 8.7%; p = 0.0008), cardiac death (4.9% vs. 4.0%; p = 0.003) and ID-TLR (10.9% vs. 10.2%; p = 0.02) compared with men. By multivariable analysis, female sex was an independent predictor of MACE (hazard ratio [HR:]: 1.14; 95% confidence interval [CI:]: 1.01 to 1.30; p = 0.04) and ID-TLR (HR: 1.23; 95% CI: 1.05 to 1.44; p = 0.009) but not all-cause death (HR: 0.91; 95% CI: 0.75 to 1.09; p = 0.30) or cardiac death (HR: 0.97; 95% CI: 0.73 to 1.29; p = 0.85). CONCLUSIONS In the present large-scale, individual patient data pooled analysis of contemporary PCI trials, women had a higher risk of MACE and ID-TLR compared with men at 5 years following PCI.

中文翻译：

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经皮冠状动脉介入治疗后女性和男性的长期结果

背景 对经皮冠状动脉介入治疗 (PCI) 后性别相关结果的研究报告了相互矛盾的结果。目的 本研究的目的是检查 PCI 后 5 年心血管结局的性别相关风险。方法作者汇集了来自 21 项随机 PCI 试验的患者水平数据，并评估了性别与主要不良心脏事件 (MACE)（心脏死亡、心肌梗死 [MI] 或缺血驱动的靶病变血运重建 [ID-TLR]）之间的关联以及它的各个组件在 5 年。结果 在 32,877 名患者中，9,141 (27.8%) 名是女性。与男性相比，女性年龄更大，体重指数更高，高血压和糖尿病更频繁，手术或经皮血运重建史更少。通过血管造影核心实验室分析，女性病变具有较小的参考血管直径和较短的病变长度。5 年时，女性的未调整 MACE 发生率更高（18.9% 对 17.7%；p = 0.003）、全因死亡（10.4% 对 8.7%；p = 0.0008）、心脏死亡（4.9% 对 4.0） %；p = 0.003）和 ID-TLR（10.9% 对 10.2%；p = 0.02）与男性相比。通过多变量分析，女性是 MACE（风险比 [HR：]：1.14；95% 置信区间 [CI：]：1.01 至 1.30；p = 0.04）和 ID-TLR（HR：1.23；95%）的独立预测因子CI：1.05 至 1.44；p = 0.009）但不是全因死亡（HR：0.91；95% CI：0.75 至 1.09；p = 0.30）或心源性死亡（HR：0.97；95% CI：0.73 至 1.29；p = 0.85）。结论 在当前对当代 PCI 试验进行的大规模个体患者数据汇总分析中，女性在 PCI 后 5 年内发生 MACE 和 ID-TLR 的风险高于男性。