TY - JOUR
T1 - Time Trends in Major Adverse Cardiovascular Events After Percutaneous Coronary Intervention
T2 - Meta-Analysis on Sex Differences
AU - Shojaei, Shayan
AU - Mousavi, Asma
AU - Soleimani, Hamidreza
AU - Takaloo, Fatemeh
AU - Roudsari, Peyvand Parhizkar
AU - Salabat, Dorsa
AU - Shahmohamady, Amirreza
AU - Mehrani, Mehdi
AU - Seilani, Parisa
AU - Ashraf, Haleh
AU - Nelson, John
AU - Thachil, Rosy
AU - Iskander, Fady
AU - Khan, Safi U.
AU - Khurram, Nasir
AU - Hosseini, Kaveh
N1 - Publisher Copyright:
© 2025 The Authors
PY - 2025/2
Y1 - 2025/2
N2 - Background: Percutaneous coronary intervention (PCI) is considered the procedure of choice for patients with acute coronary syndrome (ACS), as it significantly improves cardiovascular outcomes. However, considerable uncertainty persists regarding the potential sex differences in PCI outcomes, due to conflicting results in previous studies. Objectives: This meta-analysis aims to evaluate potential sex-related differences in cardiovascular adverse outcomes after PCI among ACS patients. Methods: The primary outcome was major adverse cardiovascular events (MACE) and its components. Outcomes were examined in various time frames including: short-term (within 1 month after PCI), mid-term (within 1 year), and long-term (within >1 year). A random effects model was used to estimate risk ratios (RR) and 95% CIs. Results: Among 32 trials, at short-term, PCI was associated with a higher risk of MACE (risk ratio [RR]: 1.43; 95% CI: 1.10-1.86), all-cause mortality (RR: 2.51; 95% CI: 1.70-3.71), and myocardial infarction (RR: 1.33; 95% CI: 1.00-1.77) in women compared with men. Over the long-term, women had a higher risk of MACE (RR: 1.11; 95% CI: 1.01-1.22), all-cause mortality (RR: 1.29; 95% CI: 1.17-1.42), and cardiovascular mortality (RR: 1.30; 95% CI: 1.11-1.52), when compared with men. However, the analysis for stroke and repeat revascularization showed no significant difference between the 2 groups in the long- and short-term. Conclusions: In the meta-analysis of PCI-related trials in ACS, women have a higher risk of adverse cardiovascular outcomes compared with men.
AB - Background: Percutaneous coronary intervention (PCI) is considered the procedure of choice for patients with acute coronary syndrome (ACS), as it significantly improves cardiovascular outcomes. However, considerable uncertainty persists regarding the potential sex differences in PCI outcomes, due to conflicting results in previous studies. Objectives: This meta-analysis aims to evaluate potential sex-related differences in cardiovascular adverse outcomes after PCI among ACS patients. Methods: The primary outcome was major adverse cardiovascular events (MACE) and its components. Outcomes were examined in various time frames including: short-term (within 1 month after PCI), mid-term (within 1 year), and long-term (within >1 year). A random effects model was used to estimate risk ratios (RR) and 95% CIs. Results: Among 32 trials, at short-term, PCI was associated with a higher risk of MACE (risk ratio [RR]: 1.43; 95% CI: 1.10-1.86), all-cause mortality (RR: 2.51; 95% CI: 1.70-3.71), and myocardial infarction (RR: 1.33; 95% CI: 1.00-1.77) in women compared with men. Over the long-term, women had a higher risk of MACE (RR: 1.11; 95% CI: 1.01-1.22), all-cause mortality (RR: 1.29; 95% CI: 1.17-1.42), and cardiovascular mortality (RR: 1.30; 95% CI: 1.11-1.52), when compared with men. However, the analysis for stroke and repeat revascularization showed no significant difference between the 2 groups in the long- and short-term. Conclusions: In the meta-analysis of PCI-related trials in ACS, women have a higher risk of adverse cardiovascular outcomes compared with men.
KW - acute coronary syndrome
KW - major adverse cardiovascular events
KW - percutaneous coronary intervention
KW - sex differences
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U2 - 10.1016/j.jacadv.2024.101526
DO - 10.1016/j.jacadv.2024.101526
M3 - Article
AN - SCOPUS:85214314434
SN - 2772-963X
VL - 4
JO - JACC: Advances
JF - JACC: Advances
IS - 2
M1 - 101526
ER -