Sex-Stratified Long-Term Outcome After Percutaneous Coronary Intervention: A Pooled Analysis of the SORT OUT All-Comer Trials.

BACKGROUND

Currently, the sex-differentiated outcome after percutaneous coronary intervention (PCI) favors male sex in most studies. In this study, we aimed to investigate the age-adjusted impact of sex on long-term outcome.

METHODS

The study was an observational, prospective, multicenter, cohort study with pooling of 5-year results of the randomized controlled all-comer stent trials SORT OUT (Scandinavian Organization for Randomized Trials With Clinical Outcome) III, V, VI, VII, VIII, and IX conducted from 2006 to 2017. All patients were followed for 5 years. The predefined main outcome was a major adverse cardiac event (MACE); a composite end point comprising all-cause death, spontaneous myocardial infarction, and target lesion revascularization assessed by a clinical event committee. MACE difference across sex was assessed by incidence rate ratios at 5 years adjusted for age and predefined risk factors.

RESULTS

In total, 15 242 patients (women, 3729 [24.5%]) with a mean age of 67.8±11.0 years were included in the study, with 0.2% lost to follow-up. Compared with men, women were older (women, 67.8±11.0 years; men, 64.8±10.7 years), had more hypertension and dyslipidemia but less previous MI and revascularization. MACEs occurred in 747 (21.8%) of the women and 2196 (20.5%) of the men at 5 years (unadjusted incidence rate ratio, 1.07 [95% CI, 0.98-1.16]; and adjusted incidence rate ratio, 0.91 [95% CI, 0.84-0.99]). Female sex was not associated with an increased risk in any of the individual MACE components.

CONCLUSIONS

Female sex was not associated with a poorer long-term outcome than male sex after treatment for coronary artery disease with percutaneous coronary intervention in MACEs or any of the individual components.