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

• Published in: Postgraduate medicine 2013-03, Vol.125 (2), p.100-107
• Main Authors: Bakhai, Ameet, Ferrières, Jean, James, Stefan, Iñiguez, Andres, Mohácsi, Attila, Pavlides, Gregory, Belger, Mark, Norrbacka, Krisi
• Format: Article
• Language: English
• Subjects: Acute Coronary Syndrome - economics; Acute Coronary Syndrome - surgery; acute coronary syndromes; Adolescent; Adult; Aged; Aged, 80 and over; catheter-based coronary interventions; catheterization; coronary disease; epidemiology; 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; secondary prevention; sex; Sex Factors; stents; Treatment Outcome; Young Adult
• ISSN: 0032-5481; 1941-9260; 1941-9260
• DOI: 10.3810/pgm.2013.03.2644

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.