Background The role of sex disparities in in-hospital outcomes after percutaneous coronary intervention (PCI) for acute myocardial infarction (AMI) in patients with a history of coronary artery bypass grafting (CABG) remains underexplored. This study aimed to identify sex disparities in in-hospital outcomes after PCI in patients with AMI and a history of CABG.

Methods Using the National Inpatient Sample database, we identified patients hospitalized for AMI with a history of CABG who underwent PCI between 2016 and 2019. The primary outcome was in--hospital mortality, and the secondary outcomes were the length of hospital stay and hospitalization costs. 1:1 propensity score matching was used to minimize standardized mean differences of baseline variables and compare in--hospital outcomes.

Results In total, 75,185 weighted hospitalizations of patients who underwent PCI were identified, with 25.2% being female patients. Compared with male patients, female patients exhibited elevated risks of in-hospital mortality (3.72% vs. 2.85%, p = 0.0095), longer length of stay (4.64 days vs. 3.96 days, p < 0.001), and higher hospitalization costs ($112,594.43 vs. $107,020.54, p = 0.0019). After propensity score matching, female patients had higher in-hospital mortality rates than male patients (3.81% vs. 2.89%, p = 0.028). Multivariable logistic regression (adjusted odds ratio [aOR]: 1.48; 95% confidence interval [CI]: 1.14–1.92) and propensity score matching (aOR: 1.34; 95% CI: 1.03–1.73) showed a consistently higher risk of in-hospital mortality among female patients than among male patients. Female patients aged >60 years were more vulnerable to in-hospital mortality than were their male counterparts (3.06% vs. 4.15%, p = 0.0003, aOR: 1.55; 95% CI: 1.18–2.04).

Conclusions Female patients who underwent PCI for AMI with a history of CABG had a higher in-hospital mortality rate, which was particularly evident among older patients aged >60 years. Therefore, sex- and age-specific investigations and interventions are required to reduce disparities within this high-risk population.

The authors have declared no competing interest.

The author(s) received no specific funding for this work.

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This study was approved by the Institutional Review Board of Ningxia Medical University.

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The third party data underlying the results presented in this study are available upon request from the Healthcare Cost and Utilization Project (HCUP) - National (Nationwide) Inpatient Sample (NIS) via their website (https://www.hcup-us.ahrq.gov/nisoverview.jsp). All interested researchers can access the data through HCUP directly. The authors of this study are not permitted to share the data or make it publicly available as per the data use agreement with HCUP. The authors did not have any special access privileges to this data.