Sex Disparities in In-Hospital Outcomes After Percutaneous Coronary Intervention (PCI) in Patients With Acute Myocardial Infarction and a History of Coronary Artery Bypass Grafting (CABG): A Cross-Sectional Study.

Background And Aims: The role of sex disparities in in-hospital outcomes after percutaneous coronary intervention (PCI) for acute myocardial infarction (AMI) in patients with a history of coronary artery bypass grafting (CABG) remains underexplored. This study aimed to identify sex disparities in in-hospital outcomes after PCI in patients with AMI and a history of CABG.

Methods: Using the National Inpatient Sample database, we identified patients hospitalized for AMI with a history of CABG who underwent PCI between 2016 and 2019. 1:1 propensity score matching was used to minimize standardized mean differences of baseline variables and compare in--hospital outcomes.

Results: In total, 75,185 weighted hospitalizations of patients were identified. Compared with male patients, female patients exhibited elevated risks of in-hospital mortality (3.72% vs. 2.85%; adjusted odds ratio [aOR] 1.48; 95% confidence interval [CI] 1.14-1.93), major adverse cardiac or cerebrovascular events (MACCEs) (4.96% vs. 3.75%; aOR 1.46; 95% CI 1.18-1.82), bleeding (4.91% vs. 3.01%; aOR 1.56; 95% CI 1.27-1.79), and longer length of stay (4.64 days vs. 3.96 days; 0.42; 95% CI 0.28-0.55). After propensity matching, female patients remained associated with increased risks of in-hospital mortality (3.81% vs. 2.81%; aOR 1.37; 95% CI 1.06-1.78), MACCEs (5.08% vs. 3.84%; aOR 1.35; 95% CI 1.08-1.70), bleeding (5.03% vs. 3.11%; aOR 1.57; 95% CI 1.24-2.00), and longer length of stay (4.61 ± 4.76 days vs. 4.06 ± 4.10 days; 0.39; 95% CI 0.18-0.59). Female patients aged > 60 years were more vulnerable to in-hospital mortality than were their male counterparts (3.06% vs. 4.15%; aOR 1.56; 95% CI 1.18-2.05).

Conclusions: Female patients who underwent PCI for AMI with a history of CABG had higher risks of in-hospital mortality, MACCEs, bleeding, and longer length of stay, with in-hospital mortality rates being particularly pronounced among older patients.