Abstract Body (Do not enter title and authors here): Background: Percutaneous coronary intervention (PCI) is considered procedure of choice in patients with acute coronary syndrome (ACS). However, whether outcomes of PCI differ by sex remains uncertain.
Hypothesis: This systematic review and meta-analysis aims to evaluate potential sex-related differences in major adverse cardiovascular events (MACE) after PCI among ACS patients in different timeframes.
Methods: We conducted a systematic search of Pubmed, Embase, Cochrane, and ClinicalTrials databases to identify relevant randomized controlled trials with ACS patients undergoing PCI. The primary outcome of our article was study defined MACE components (all-cause mortality, cardiovascular mortality, myocardial infarction (MI), stroke, and need for revascularization). We evaluated Our outcomes in different timeframes, short-term (within 1 month after PCI), mid-term (1 month to 1 year), and long-term (>1 year). We used a random-effects model to estimate risk ratios (RR) and 95% confidence intervals (CI). Egger’s test and funnel plots were used to assess publication bias.
Results: Among 32 trials (78,846 patients; 59,491 men and 19,355 women), at short-term, PCI was associated with higher risk of all-cause mortality (RR=2.51, 95% CI 1.70; 3.71), MI (RR=1.33, 95% CI 1.00; 1.77), and stroke (RR=4.35, 95% CI 1.35; 14.04) in women compared with men. Concerning mid-term outcomes, the male group exhibited significantly lower risk of all-cause mortality, cardiovascular mortality, MI, and stroke compared to women group (RR=1.44, 95% CI 1.21; 1.72), (RR=1.29, 95% CI 1.00; 1.66), (RR=1.16, 95% CI 1.04; 1.28), and (RR=1.49, 95% CI 1.15; 1.93), respectively. Eventually, In the long-term, women were found to have a higher risk of both all-cause mortality (RR=1.27, 95% CI 1.16; 1.40) and cardiovascular mortality (RR=1.26, 95% CI 1.08; 1.48) compared to men. However, in terms of the need for revascularization, men had a higher risk compared to women (RR=0.87, 95% CI 0.77; 0.98).
Conclusion: In the meta-analysis of PCI related trials in ACS patients, women have a higher risk of cardiovascular events compared to men in different timeframes.