Is PCI beneficial in women with stable heart disease?

This paper studied differences in men and women when they received optimal medical therapy plus a percutaneous coronary intervention (PCI). There were no significant differences in outcome whether patients received PCI or optimal medical therapy alone. 

Optimal medical therapy refers to achieving good blood pressure control and levels of fat in the body. A PCI is a procedure done to improve blood flow to the heart. In a previous analysis of patients with stable ischemic heart disease (not enough blood flow to the heart, but symptoms are controlled), women undergoing PCI had lower rates of death or heart attack. It is suggested that women may benefit more than men if they received PCI on top of optimal medical therapy. 

169 females received PCI plus optimal medical therapy while 169 females received optimal medical therapy alone. Meanwhile, 979 males received PCI plus optimal medical therapy and 968 received optimal medical therapy alone. Compared to men, women were more likely to have higher fat levels, worse kidney function, and worse angina (chest pain). Patients were followed for an average 4.6 years. 

There was no significant difference in rates of death and heart attack when comparing those who had PCI to those who had medical therapy alone in men and women.

Women who had PCI were 41% less likely to be hospitalized for heart failure than those who had optimal medical therapy alone. There was no difference in men. Women receiving PCI were 28% less likely to need another procedure than women who received optimal medical therapy alone. Men who received PCI were 16% less likely to need another procedure than women who received optimal medical therapy alone. 

The authors found no significant difference in the rates of death and heart attack between patients who received PCI or optimal medical therapy alone. However, women receiving PCI benefitted more than men, with less hospitalization for heart failure.

Furthur studies are needed.