Despite the advances in the interventional technology, devices, and pharmacotherapy which have translated into better clinical outcome of patients undergoing percutaneous coronary intervention (PCI), there is still a disparity in the clinical outcome between women and men undergoing PCI.

We retrospectively enrolled a nationwide cohort of all Korean PCI performed in year 2011. Primary outcome was 5-year cumulative incidence of major adverse clinical event (MACE) consisting of all-cause death, revascularization, critically ill cardiovascular status, or stroke. Outcomes adjusted with age and propensity for clinical characteristics were additionally compared.

In unadjusted analysis, female (N=15710) were older (69.7±9.7 versus 62.0±11.1year, p<0.001) and had higher frequency of comorbidities including hypertension, hyperlipidemia, and diabetes compared to male (N=33073) (p<0.001, all). female had higher 5-yearcumulative incidence of MACE than men (21.8% versus 17.3%; hazard ratio [HR] 1.29, 95% confidential interval [CI] 1.23 ? 1.34; p<0.001). However, in the analysis of age and propensity score-matched 14461 pairs, women had lower 5-year mortality risk (20.3% versus 26.1%, HR 0.85, 95% CI 0.82-0.88, p<0.001). This finding was consistent in subgroup analyses of age, risk factors, and clinical presentation such as acute myocardial infarction or stable angina (p<0.05, all).

The apparent worse outcome in women can be explained by older age and more common comorbidities in women. After adjusting these disadvantages, women had better outcome after PCI than men.