Background: Older age has been proved to be an important risk factor for coronary artery disease (CAD). Previous studies have reported that women undergoing percutaneous coronary intervention (PCI) for CAD have worse outcomes than men. This study aimed to evaluate the impact of older age and gender on long-term outcomes after PCI in all-comer CAD patients.
Methods: We investigated data on CAD obtained from the SHINANO Registry, a prospective, observational, and multicenter cohort study from 2012 to 2013 in Nagano, which shows the highest life expectancy among all prefectures in Japan. Enrolled patients were divided into older (>80 years) and younger (≤80 years) groups. The association between gender and 3-year outcomes (all-cause death, Q-wave myocardial infarction, target lesion revascularization, bleeding events, and stroke) was examined in both groups.
Results: Of 1724 all-comer CAD patients, 335 were older (140 women) and 1389 were younger (267 women). In an age-based analysis, although the older group showed a higher incidence of all-cause death than the younger group in both genders [hazard ratio (HR) in women: 3.08; 95% confidence interval (CI): 1.79-5.30; p < 0.01, HR in men: 3.50; 95% CI: 2.47-4.95; p < 0.01], there were no differences in other outcomes. In a gender-based analysis, women were more likely to have dyslipidemia and a higher low-density lipoprotein level than men according to the baseline characteristics in both groups. In addition, women had higher SYNTAX scores and higher prevalence of acute coronary syndrome than men in the older group. However, the 3-year clinical outcomes showed no difference between women and men in both groups (Table).
Conclusions: The 3-year clinical outcomes did not significantly differ regardless of age and gender in CAD patients undergoing PCI. Although the aging population has increased worldwide, PCI should be performed for all CAD patients without hesitation based on age and gender.