Treatment, outcomes, costs, and quality of life of women and men with acute coronary syndromes who have undergone percutaneous coronary intervention: results from the antiplatelet therapy observational registry

Postgrad Med. 2013 Mar;125(2):100-7. doi: 10.3810/pgm.2013.03.2644.

Abstract

Background: Treatment, outcomes, costs, and quality of life after percutaneous coronary intervention (PCI) were compared between women and men with acute coronary syndromes (ACS) using data from the Antiplatelet Therapy Observational Registry (APTOR).

Methods: Fourteen European countries participated in this noninterventional, prospective, observational cohort registry, which enrolled patients with ACS who underwent PCI from 2007 to 2009. The 12-month outcomes included bleeding, cardiovascular events, and mortality. Quality of life was measured using the EQ-5D™ (EuroQol Group) health index and the visual analog scale.

Results: The APTOR registry included 4546 patients, of whom 1047 (23%) were women and 3499 (77%) were men. The women were older (mean age, 67 vs 61 years) and had higher rates of diabetes mellitus and hypertension. A greater proportion of the men were smokers (40% vs 30%). Approximately 70% of the patients underwent PCI on the day of the qualifying ACS event. Women and men received similar medications at the time of PCI, hospital discharge, and 12-month follow-up visit. Bleeding, cardiovascular events, and mortality occurred at higher rates in women than in men, but the differences were not statistically significant. At 12 months post-PCI, women reported lower quality-of-life scores on the EQ-5D™ health index and the visual analog scale than did men. The mean total cost of care was £6252 (€7189) for women and £5841 (€6717) for men; the differences may be driven by resource use after discharge from the hospital.

Conclusion: Women with ACS tended to be older and had more comorbidities than men, but both sexes experienced similar outcomes after 1 year. This study indicated no differences in treatment between sexes.

Publication types

  • Comparative Study
  • Evaluation Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Acute Coronary Syndrome / economics
  • Acute Coronary Syndrome / surgery*
  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Europe
  • Female
  • Follow-Up Studies
  • Health Care Costs / statistics & numerical data*
  • Humans
  • Kaplan-Meier Estimate
  • Logistic Models
  • Male
  • Middle Aged
  • Percutaneous Coronary Intervention / economics*
  • Proportional Hazards Models
  • Quality of Life*
  • Registries
  • Sex Factors
  • Treatment Outcome
  • Young Adult