***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Background —Diagnosis of coronary artery disease in women is more difficult because of lower specificity of symptoms and diagnostic accuracy of noninvasive testing . We sought to examine the relationship between gender and cardiac biomarkers in patients with unstable angina (UA)/non – ST-segment elevation myocardial infa rct ion ( NSTEMI ) . Methods and Results —In the TACTICS-TIMI 18 , OPUS-TIMI 16 , and TIMI 11 studies , baseline sample s were analyzed in the Thrombolysis In Myocardial Infa rct ion ( TIMI ) biomarker core laboratory . We examined the relationship between gender and elevated biomarkers . Of 1865 patients from TACTICS-TIMI 18 , 34 % were women . Fewer women had elevated creatine kinase-MB or troponins , whereas more had elevated high-sensitivity C-reactive protein or brain natriuretic peptide . Presence of ST-segment deviation and TIMI risk scores were not significantly different . This pattern was confirmed in TIMI 11 and OPUS-TIMI 16 . The prognostic value of the markers in TACTICS-TIMI 18 was similar in women and men . When a multimarker approach was examined , a greater proportion of high-risk women were identified . Marker-positive patients of both genders had improved outcome with an invasive strategy ; however , marker-negative women appeared to have improved outcomes with a conservative strategy . Conclusions —In patients with UA/NSTEMI , there was a different pattern of presenting biomarkers . Men were more likely to have elevated creatine kinase-MB and troponins , whereas women were more likely to have elevated C-reactive protein and brain natriuretic peptide . This suggests that a multimarker approach may aid the initial risk assessment of UA/NSTEMI , especially in women . Further research is necessary to eluci date whether gender-related pathophysiological differences exist in presentation with acute coronary syndromes Background Several studies have suggested sex‐related differences in diagnostic and invasive therapeutic coronary procedures . Methods and Results Data from consecutive patients who were enrolled in the Coronary Angiography and PCI Registry of the German Society of Cardiology were analyzed . We aim ed to compare sex‐related differences in in‐hospital outcomes of patients undergoing percutaneous coronary intervention ( PCI ) for stable coronary artery disease , non‐ST elevation acute coronary syndromes , ST elevation myocardial infa rct ion , and cardiogenic shock . From 2007 until the end of 2009 data from 185 312 PCIs were prospect ively registered : 27.9 % of the PCIs were performed in women . Primary PCI success rate was identical between the sexes ( 94 % ) . There were no sex‐related differences in hospital mortality among patients undergoing PCI for stable coronary artery disease , non‐ST elevation acute coronary syndromes , or cardiogenic shock except among ST elevation myocardial infa rct ion patients . Compared to men , women undergoing primary PCI for ST elevation myocardial infa rct ion have a higher risk of in‐hospital death , age‐adjusted odds ratio ( 1.19 , 95 % CI 1.06‐1.33 ) , and risk of ischemic cardiac and cerebrovascular events ( death , myocardial infa rct ion , transient ischemic attack/stroke ) , ( age‐adjusted odds ratio 1.19 , 95 % CI 1.16‐1.29 ) . Furthermore , access‐related complications were twice as high in women , irrespective of the indication . Conclusions Despite identical technical success rates of PCI between the 2 sexes , women with PCI for ST elevation myocardial infa rct ion have a 20 % higher age‐adjusted risk of death and of ischemic cardiac and cerebrovascular events . Further research is needed to determine the reasons for these differences BACKGROUND Gender and age are non-modifiable factors influencing clinical outcomes in acute coronary syndromes ( ACS ) . There is evidence that coronary artery disease pathophysiology varies in women . We therefore evaluated the effect of age and gender on clinical outcomes in patients with ACS undergoing percutaneous coronary interventions ( PCI ) .  METHODS Among 3178 ( 25 % female ) consecutive ACS patients who underwent PCI at Liverpool Hospital , Sydney from 2003 to 2010 , using femoral access in 98 % of cases , we determined late events including mortality , myocardial infa rct ion and bleeding according to Bleeding Academic Research Consortium ( BARC ) criteria . RESULTS Females compared with males were older ( median 68 vs. 60 years ; p<0.001 ) , and were more likely to have diabetes ( 30 % vs. 22 % p<0.001 ) , hypertension ( 62 % vs. 49 % , p<0.001 ) , anaemia ( 26 % vs. 15 % , p<0.001 ) , and renal impairment ( 43 % vs. 20 % , p<0.001 ) ; they were more likely to be non-smokers ( 19 % vs. 30 % , p<0.001 ) . Females had less class B2/C lesions ( 64 % vs.68 % , p=0.048 ) , but had more calcified lesions ( 20 % vs. 11 % , p<0.001 ) , and smaller stent diameters ( 2.75[2.5 - 3.0 ] vs. 3.0[2.75 - 3.5 ] mm , p<0.001 ) . Females had higher three-year mortality rates ( 11 % vs. 7.0 % , p=0.001 ) , and more type 2 - 5 BARC bleeding post-PCI ( 22 % vs. 16 % , p=0.003 ) . Among patients under 55 years ( n=988 ) , mortality and bleeding were higher in females ( 6.0 % vs. 3.0 % , p=0.028 ) and ( 26 % vs. 14 % , p=0.001 ) respectively . There was no effect of gender on mortality or bleeding in patients 55 years and over . However , on multivariable stepwise regression analysis , female gender was not an independent predictor of mortality , but was a significant predictor of bleeding ( OR=1.84 [ 95 % CI:1.38 - 2.45 ] , p<0.001 ) . CONCLUSION Bleeding and mortality were higher in younger females with ACS who underwent PCI . While females had more post-PCI bleeding events , which were associated with late mortality , gender per se was not an independent predictor for mortality There are conflicting reports in the literature regarding the role of sex on the in-hospital mortality of patients with acute myocardial infa rct ion . The objective of this study is to determine whether there are gender differences in in-hospital mortality and angiographic findings of patients with acute ST-segment elevation myocardial infa rct ion ( STEMI ) undergoing percutaneous coronary intervention ( PCI ) .  We conducted a prospect i ve study of all patients admitted to University Hospital Center Split , Croatia with STEMI from 2004 to 2008 who underwent PCI . From March 2004 throughout September 2008 , 488 patients with STEMI underwent PCI ( 364 men , 74.6 % ; 124 women , 25.4 % ) . Compared with men , women were significantly older ( mean age , 67.3 vs. 60.3 years ; p < 0.001 ) . Men had a significantly higher proportion of circumflex artery occlusion ( 19.5 % vs. 10.5 % , p = 0.022 ) . A higher proportion of men had a multivessel disease than women ( 56.8 % vs. 41.9 % ; p = 0.004 ) . In-hospital mortality was significantly higher among women ( 11.3 % vs. 4.6 % ; p = 0.002 ) but after adjustment for the baseline difference in age , the female sex was not an independent predictor of in-hospital mortality ( adjusted OR 1.15 ; 95 % CI 0.82 - 1.84 ) . In men , occlusions of left anterior descending artery showed higher mortality rate than occlusions of other coronary arteries ( LM 0 % , LAD 7.3 % , Cx 2.8 % , RCA 0.7 % , p = 0.03 ) . According to our results female gender is not an independent predictor of in-hospital mortality after percutaneous coronary intervention . In men , occlusions of left anterior descending arteries are associated with higher mortality rate comparing to occlusions of other coronary arteries Women with non-ST-elevation acute coronary syndromes ( NSTACSs ) may have better outcomes than men , but the effect of NSTACSs in women undergoing percutaneous coronary intervention ( PCI )  has not been examined . We performed a prospect i ve , multicenter , cohort study of consecutive patients who underwent PCI for NSTACS and stable angina during 3 National Heart , Lung , and Blood Institute Dynamic Registry recruitment waves ( 1997 to 2002 ) to examine the effect of female gender on adverse clinical events after PCI or stable angina for NSTACS . The primary end point was the combined rate of death , myocardial infa rct ion , or rehospitalization for cardiac causes at 1 year . Compared with men with NSTACS ( n = 2,124 ) , women ( n = 1,338 ) were older and more often had hypertension , diabetes mellitus , and history of heart failure ( p < 0.001 for all ) , whereas multivessel disease was less frequent ( p < 0.01 ) . Procedural success and in-hospital adverse event rates were similar . Women with NSTACS had the highest 1-year rate of death/myocardial infa rct ion/cardiac rehospitalization compared with women with stable angina pectoris ( n = 462 ) or men ( n = 995 ; women with NSTACS 37.6 % , men with NSTACS 29.8 % , women with stable angina 29.4 % , men with stable angina 27.7 % , p < 0.001 ) . The higher rate remained after adjustment for differences in baseline characteristics ( adjusted hazard ratio 1.37 , 95 % confidence interval 1.20 to 1.56 ) . Among women , NSTACS conferred a significantly higher risk for adverse events compared with stable angina ( adjusted hazard ratio 1.41 , p = 0.001 ) , whereas the risk of adverse events was not different in men ( adjusted hazard ratio 1.05 , p = 0.5 ) . In conclusion , women undergoing PCI for NSTACS  have a higher risk of major adverse cardiac events than men or women undergoing PCI for stable angina The incidence of adverse outcomes after percutaneous coronary intervention ( PCI ) is higher in women than in men . Statins reduce the likelihood of cardiovascular events arising in patients with coronary artery disease ( CAD ) , but the impact of gender difference on long-term outcomes of PCI for CAD under statin treatment has not been established . We prospect ively enrolled 3,580 consecutive patients with CAD who were treated by PCI at our institution between 2000 and 2011 . Among these , 2,009 ( 43.9 % ; male , n = 1619 ; female , n = 390 ) were under statin therapy at the time of PCI . We evaluated the incidence of major adverse cardiac events ( MACE ) including all-cause death and acute coronary syndrome ( ACS ) . Age was significantly more advanced and the prevalences of hypertension and chronic kidney disease were higher among the female , than the male patients . Low-density lipoprotein cholesterol levels were significantly higher in women than in men ( 111.5 ± 38.9 vs. 107.5 ± 3 3.9 mg/dL , p = 0.04 ) . During a median follow-up period of 6.3 years , MACE that occurred in 336 ( 16.7 % ) patients included 206 ( 10.2 % ) with all-cause death and 154 ( 7.7 % ) with ACS . The cumulative rate of MACE tended to be higher in women than in men but the difference did not reach significance ( 19.7 vs. 16.0 % ; p = 0.08 , log-rank test ) . Multivariable Cox regression analysis showed that being female was not associated with MACE after adjusting for age ( HR 1.22 ; 95 % CI 0.94–1.57 ; p = 0.13 ) and other variables ( HR 1.14 ; 95 % CI 0.86–1.49 ; p = 0.35 ) . Long-term clinical outcomes were comparable between male and female patients with coronary artery disease who were administered with statins and underwent PCI even though the baseline characteristics were worse among the females The present study assessed the impact of early administration of abciximab in female and male patients with ST-segment elevation myocardial infa rct ion ( STEMI ) transferred for primary angioplasty ( PPCI ) . Data were gathered for 1,650 consecutive patients with STEMI transferred for PPCI from hospital networks in seven countries in Europe from November 2005 to January 20 
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Conclusions : The systematic review and meta- analysis suggests that the prognosis of male patients with coronary artery disease after percutaneous coronary intervention is better than that of females , except for long-term revascularization