Influence Of Sex On Long-term Outcomes After Percutaneous Coronary Intervention In Patients With Diabetes

Objective:To compare the sexual difference of clinical characteristics in patients with diabetes mellitus(DM) and coronary heart disease(CHD) and analyze the influence of long term outcomes after percutaneous coronary intervention(PCI).Menthods:A total of 431 patients with DM and CHD who had underwent PCI in First Hospital Of Shan Xi Medical University from January 2009 to November 2013 were enrolled in this study. there were 301 males and females in this restrospective study. Clinical features,coronary angiographic results, after-hospital medications of antithrombotic agents and other cardiovascular drugs and incidence of one-year all-cause mortality and major adverse cardiocerebrovascular events(MACCE) were collected and analyzed for gender difference and the factors for all-cause mortality and MACC.Results:Among the risk factors for MD and CHD, the prevalence of smoking and body mass were significantly higher in the males than in the females(53.8% VS 8.5%,P<0.001;74.90±10.88 VS 63.57±8.21,P <0.001).while, the females had older age of onset and higher proportion of hypertension morbidity than males(63.53±8.74 VS 58.68±9.69,P<0.001;72.3% VS 57.5%,P=0.004). In the incidence of acute myocardial infarction(AMI),particularly in ST-segment elevation myocardial infarction(STEMI) males was higher than females(52.5% VS 38.5%, P=0.007; 71.5% VS 52.0%, P=0.011). There were no significant difference in previous history,complication and coronary angiographic results between males and females(P>0.05).The serious lesions were both found in triple-vessel and four-vessel disease between males and females(59.1% VS 54%,12.0% VS 11.5%;P>0.05).At one-year clinical follow-up: There were no significant difference in after-hospital medications of antithrombotic agents(100% VS 99.5%,P>0.474)and other cardiovascular drugs(BBs: 80.6% VS 81.0%,P=0.936; ACEI/ARB: 58.2% VS 53.0%,P=0.397; Statins:92.9% VS 97%,P=0.147) and incidence of 1 year all-cause mortality(2.6% VS 2.0%,P=0.758)and MACC(AMI:2.6% VS 2.0%, P=0.758; Stroke:1.0% VS 2.1%, P=0.473)between males and females.Multi-logistic regression analysis showed that female gender was not an independent predictor for one-year mortality or MACCE, while serum creatinine(Scr) [OR=13.066,95%CI(3.727,45.807)P <0.001] was an independent predictor for stroke.Conclusion:Gender itself is not an independent predictor for one-year mortality or MACCE despite older age of onset,higher proportion of hypertension morbidity in female patients and higher proportion of smoking, body mass and AMI(especialy in STEMI) in male patients.