Background. The National Heart, Lung, and Blood Institute (NHLBI) Percutaneous Transluminal Coronary Angioplasty (PICA) 1978(PICA) -1981 Registry cohort indicated that PTCA risk was higher and efficacy was lower in women. Data from the 1985-1986 PTCA Registry are used to address the question of whether compared with men, women still have a worse outcome after PICA. Methods and Results. The 1985-1986 NHLBI PTCA Registry collected data on consecutive, first-PTCA cases at 16 centers. Initial

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... s are reported for 2,136 patients, 546 of whom were women. Four-year follow-up status was available on 95% of the cohort. Although women were an average of 4.5 years older than the male patients and had more cardiovascular risk factors and more severe angina, their coronary artery disease as assessed by angiography was not more extensive. Rates of angiographic success on a per-lesion basis were similar for women and men (89%o versus 88%), and the clinical success rates (79%,0) were the same. Women had more initial complications (29% versus 20%1, p<0.001) and a considerably higher procedural mortality rate (2.6% versus 0.3%, p<0.001). For patients who survived the initial procedure, 4-year survival was similar for men and women. At 4 years, women had slightly fewer events (myocardial infarction, repeat PTCA, and/or coronary artery bypass grafting). Despite the higher proportion of women reporting the presence of angina and medication use at 4 years, the proportion reporting improvement in symptomatic status was similar to that of men. Conclusions. Women undergoing PTCA have a higher procedural mortality risk than men; this is explained in part by their worse cardiovascular risk factor profile. Otherwise, the success rate and long-term prognosis after PITCA are excellent, and PTCA should be considered for women in need of revascularization. (Circulation 1993;87:720-727) KEY WORDs * ischemic heart disease * women * percutaneous transluminal coronary angioplasty * registries R ecent articles1'2 have noted the underrepresenta-From the Department of Epidemiology (all recent reports indicate that women are no longer at a disadvantage compared with men who undergo CABG. The early, 1978-1981 NHLBI PTCA Registry cohort indicated that PTCA risk was higher and efficacy was lower in women. The differences between women and men in the 1985-1986 registry, their baseline medical history, and the short-and long-term results of PTCA are the focus of this report. For outcome by sex differences, we investigated why they occurred by taking into account differences in risk factors including age, medical history, and angina presentation. Methods The 1985-1986 NHLBI PTCA Registry collected data from 16 clinical centers that participated in the earlier registry. Data on characteristics and initial baseline results were collected on consecutive, first-PTCA cases at each center. Once patients gave written informed consent, follow-up information was obtained annually by telephone interview. Patients will be followed for 10 years. The data were compiled, managed, and analyzed at the Data Coordinating Center at the by guest on July 21, 2018 http://circ.ahajournals.org/ Downloaded from by guest on July 21, 2018