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Limited data exist on contemporary gender-related differences in long-term outcomes of coronary patients receiving drug eluting stents. In this study we evaluate men (M) and women (W) differences for 2-year target lesion failure (TLF) in an unselected consecutive series of patients treated with the everolimus- (EES) and paclitaxel-eluting (PES) stents at a tertiary medical center.
Data on 347 consecutive patients (M 220, W 125) stented with the EES and PES were retrospectively analyzed. The primary endpoint of the study was to compare gender related outcomes in TLF defined as the combined endpoint of cardiac death, non fatal myocardial infarction and target lesion revascularization (TLR). Secondary endpoints included TLR, target vessel failure (TVF), target vessel revascularization (TVR), acute stent thrombosis (ST) as defined by the academic research consortium (ARC) and cardiac death. The cine angiograms of the first consecutive 162 patients (M 105, W 57) were independently reviewed by a cardiologist blinded to clinical outcome and SYNTAX scoring was performed. Follow-up was achieved using medical records and/or phone calls and was censored at 2 years. Descriptive analysis was performed on all variables. Univariate analysis compared the men and women cohorts. Propensity matched analysis was performed to account for differences between M and W.
M had more prior PCI and restenotic lesions and a higher prevalence of smoking. They also had longer length of disease and received more stents than W. W were older and had higher prevalence of prior stroke. Angiographic complexity was statistically similar between the 2 groups as judged by SYNTAX scoring (M 20.8 ± 13.8, W 19.7 ± 13.9, p = 0.650). At 2 years follow up, TLF was 27.4% and 24.8% (p=0.614) with no statistical difference between TLR (23.3% vs. 21.6%), cardiac death (2.8% vs. 3.2%) and definite and probable stent thrombosis (2.3% vs. 0.0%). Propensity matched analysis showed a statistically similar TLF and TVF between M and W (20.3 ± 16 vs. 27.5 ± 22 (p=0.363) and 28.8 ± 23 vs. 35.5 ± 29 (p=0.400) respectively).
In this cohort of patients receiving EES and PES, men and women had similar outcomes at 2- year follow-up consistent with recent reports in the current era of PCI.
- 2013 American College of Cardiology Foundation