P4393Current smoking and gender difference in South Korean AMI patients who underwent PCI with DES
Authors: Kim Y H , Her A.-Y , Jeong M H , Kim B.-K , Lee S.-Y , Hong S.-J , Shin D.-H , Ahn C.-M , Kim J.-S , Ko Y.-G , Choi D , Hong M.-K , Jang Y 
Published: October 2019

Abstract

Background
There is some debate on whether or not there is a gender difference is present between current smoking and cardiovascular disease.

Purpose
We decide to evaluate the impact of sex difference on the 2-year clinical outcomes in Korean acute myocardial infarction (AMI) patients who currently smoke and who underwent percutaneous coronary intervention (PCI) with drug-eluting stents (DES).

Methods
The data of this study was obtained from the Korea Acute Myocardial Infarction (KAMIR) registry. More than fifty high-volume universites or community hospitals with facilities for primary PCI and onsite cardiac surgery participated in this KAMIR registry. A total of 12565 current smoker AMI patients were enrolled and divided into the male (n=11767, 93.6%) or female (n=798, 6.4%) group. The clinical endpoint was the occurrence of major adverse cardiac events (MACE) defined as all-cause death, recurrent myocardial infarction (re-MI), and total repeat revascularization.

Results
Before risk adjustment, the cumulative incidences of MACE (7.2% vs. 10.0%, hazard ratio [HR], 1.419; 95% confidence interval [CI], 1.125–1.790; P=0.003), all-cause death (HR, 1.988; 95% CI, 1.417–2.789; P<0.001), and re-MI (HR, 1.885; 95% CI, 1.154–3.078; P=0.011) were significantly higher in the female group compared with the male group. However, after adjustment the cumulative incidences of MACE (adjusted HR, 1.047; 95% CI, 0.756–1.450; P=0.782), all-cause death, re-MI, total repeat revascularization, TLR, TVR, and non-TVR were similar between the two groups.
Clinical outcomes at 2-year Outcomes Cumulative Events at 2-year (%) Unadjusted Adjusted* Propensity-score adjusted Male Female Log-rank Hazard Ratio (95% CI) p value Hazard Ratio (95% CI) p value Hazard Ratio (95% CI) p value MACE 819 (7.2) 78 (10.0) 0.003 1.419 (1.125–1.790) 0.003 1.047 (0.756–1.450) 0.782 1.133 (0.871–1.473) 0.352 All-cause death 283 (2.5) 38 (4.8) <0.001 1.988 (1.417–2.789) <0.001 0.764 (0.457–1.279) 0.306 1.105 (0.744–1.641) 0.620 Cardiac death 224 (1.9) 25 (3.2) 0.016 1.654 (1.094–2.500) 0.017 0.512 (0.261–1.005) 0.052 0.822 (0.511–1.322) 0.419 Re-MI 142 (1.3) 18 (2.4) 0.010 1.885 (1.154–3.078) 0.011 1.741 (0.887–3.419) 0.107 1.835 (1.109–3.375) 0.062 Total revascularization 444 (4.0) 27 (3.6) 0.594 0.900 (0.610–1.327) 0.594 1.069 (0.654–1.748) 0.789 0.956 (0.627–1.458) 0.835 TLR 121 (1.1) 8 (1.1) 0.956 0.980 (0.479–2.004) 0.956 0.955 (0.366–2.497) 0.926 0.868 (0.395–1.910) 0.726 TVR 228 (2.1) 14 (1.9) 0.726 0.908 (0.529–1.558) 0.726 1.051 (0.518–2.135) 0.890 0.935 (0.519–1.684) 0.823 Non-TVR 223 (2.0) 13 (1.7) 0.602 0.862 (0.493–1.508) 0.602 1.060 (0.536–2.097) 0.867 0.942 (0.514–1.726) 0.847

Conclusion
Before risk adjustment, a gender difference was suggested in the female group compared with the male in these current smoker South Korean AMI patients during a 2-year follow-up period. However, after adjustment, gender difference was not observed in these AMI patients with a history of current smoking.