Gender differences in patients undergoing coronary stenting in current stent era.
- Author:
Max WOO
1
;
Chang-qing FAN
;
Yung-Lung CHEN
;
Hesham HUSEIN
;
Hsiu-Yu FANG
;
Cheng-Jui LIN
;
Chiung-Jen WU
Author Information
- Publication Type:Journal Article
- MeSH: Aged; Angina Pectoris; therapy; Angina, Unstable; therapy; Angioplasty, Balloon, Coronary; adverse effects; Female; Humans; Male; Middle Aged; Sex Factors; Treatment Outcome
- From: Chinese Medical Journal 2011;124(6):862-866
- CountryChina
- Language:English
-
Abstract:
BACKGROUNDPrior studies have demonstrated worse results of women in both hospital and short-term outcomes post-percutaneous coronary intervention. However, with advanced devices like drug-eluting stents (DESs) available, there are no consistent data revealing gender impact in outcome. This study examined whether gender affected hospital outcome and showed one-year single-center patient results of coronary stenting.
METHODSThe study group included 969 consecutive patients (250 women and 719 men) undergoing coronary stenting for stable or unstable angina. Clinical events were assessed for at least 1 year post-procedure.
RESULTSCompared to men, women were older, presented more often with diabetes, hypertension, dyslipidemia, and lower creatinine clearance rate (Ccr); they had less percutaneous transluminal coronary angioplasty (PTCA) history, smaller vessel size, and shorter lesions. The hospital major adverse cardiovascular event (MACE) rate was 2.8% of women and 0.97% of men (P = 0.037). The one-year MACE rate was 10.0% of women and 10.4% of men (P = 0.874). After adjusting other covariates, women still had significantly higher hospital MACE rates (P = 0.034) and odds ratios (0.18; 95% confidence interval: 0.036-0.874). In women (n = 250), there was no statistically significant difference in hospital or one-year MACE between bare metal stent (BMS) and DES groups. Meanwhile, in men (n = 719), DES had a significant one-year improvement of MACE compared to BMS (P = 0.004). The female hospital MACE rate was five times greater than male results. However, there were similar one-year outcomes between women and men. DES currently have an advantage in long-term outcome.
CONCLUSIONSCurrently, with the use of BMS and DES, adverse hospital post-procedure cardiovascular event rate has occurred more often in women than in men. However, the MACE rate differences between women and men resolved with one year follow-up.