Gender disparities in percutaneous coronary interventions for acute myocardial infarction in Pennsylvania

Background: It has been shown that women are at greater risk than men of not receiving screening and treatment services for coronary heart disease. The purpose of this research was to determine whether there were gender disparities in the use of percutaneous coronary interventions (PCI) in the treatment of acute myocardial infarction (AMI) in Pennsylvania in 2000 and, if so, whether outcomes were affected. Methods: Data included 10,170 patients treated with PCI and 21,181 patients medically managed in Pennsylvania hospitals. Multivariate analyses were performed using logistic regression to estimate the impact of gender on PCI. In addition, we performed retrospective matching on propensity scores to compare outcomes for women who were treated with PCI to comparable groups of women and men. Results: After controlling for age, race/ethnicity, severity at admission, location of infarct, and source of admission, women had 24% lower odds than men of receiving PCI (P < 0.0001). In a propensity score-matched sample of 3023 women who received PCI and 3023 women who did not, women who received PCI were significantly less likely to die (2.3% vs. 10.4%, P < 0.0001). In a second propensity score-matched sample of 3329 women and 3329 similar men who received PCI, the difference in mortality was not statistically significant (1.59% vs. 1.92%, P = 0.39). Conclusions: These results suggest that the morbidity and mortality associated with AMI in women could be reduced by increased use of PCI and that more women admitted for AMI should receive consideration for PCI.