Gender differences in clinical outcomes after percutaneous coronary interventions with zotarolimus-eluting stents

Insights from the Korean endeavor registry

Pil Sang Song, Young Bin Song, Joo Yong Hahn, Doo Il Kim, Jeong Hoon Yang, Seung Hyuk Choi, Jin Ho Choi, Hyeon Cheol Gwon, Hun Sik Park, Sahng Lee, Kyoo Rok Han, Seung-Woon Rha, Byung Ryul Cho, Jong Sun Park, Junghan Yoon, Do-Sun Lim

Research output: Contribution to journalArticle

Abstract

BACKGROUND:: The impact of gender on outcomes after percutaneous coronary intervention (PCI) with second-generation drug-eluting stents is not known in Asian patients. The authors studied outcomes after PCI with zotarolimus-eluting stent in unselected consecutive series of Asian patients according to gender. METHODS:: Outcomes among patients treated with zotarolimus-eluting stents from multicenter registry were evaluated by gender. The primary outcome was major adverse cardiac events, composite of cardiac death, myocardial infarction and target lesion revascularization at 1 year. RESULTS:: Of 2,840 patients, 855 (30.1%) were women. Comparatively, women were older; more frequently had diabetes, hypertension, and dyslipidemia; less frequently women were current smokers, had previous myocardial infarctions and previous PCIs; were more likely to have culprit lesions in left anterior descending coronary artery; and underwent more multilesion PCIs. After adjustment for baseline differences, women were still at lower risk of major adverse cardiac events (38 [4.4%] versus 137 [6.9%], adjusted hazard ratio [HR]: 0.52, 95% confidence interval [CI]: 0.30-0.89, P = 0.018), mainly driven by target lesion revascularization (24 [2.8%] versus 106 [5.3%], adjusted HR: 0.41, 95% CI: 0.24-0.70, P = 0.001) at 1 year, although rates of cardiac death, myocardial infarction and stent thrombosis were similar between genders. These results were consistent after propensity score-matched population analysis (for major adverse cardiac events, adjusted HR: 0.36, 95% CI: 0.18-0.69, P = 0.012; for target lesion revascularization, adjusted HR: 0.32, 95% CI: 0.15-0.69, P = 0.004) and were also constant among various high-risk subgroups. CONCLUSIONS:: Despite greater baseline clinical and angiographic risk, the use of the zotarolimus-eluting stent is associated with favorable outcomes among Asian women treated with PCI.

Original languageEnglish
Pages (from-to)479-485
Number of pages7
JournalAmerican Journal of the Medical Sciences
Volume346
Issue number6
DOIs
Publication statusPublished - 2013 Dec 1

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Percutaneous Coronary Intervention
Stents
Registries
Confidence Intervals
Myocardial Infarction
Propensity Score
Drug-Eluting Stents
Dyslipidemias
Coronary Vessels
Thrombosis
zotarolimus
Hypertension
Population

Keywords

  • Drug-eluting stent
  • Gender
  • Percutaneous transluminal coronary angioplasty

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Gender differences in clinical outcomes after percutaneous coronary interventions with zotarolimus-eluting stents : Insights from the Korean endeavor registry. / Song, Pil Sang; Song, Young Bin; Hahn, Joo Yong; Kim, Doo Il; Yang, Jeong Hoon; Choi, Seung Hyuk; Choi, Jin Ho; Gwon, Hyeon Cheol; Park, Hun Sik; Lee, Sahng; Han, Kyoo Rok; Rha, Seung-Woon; Cho, Byung Ryul; Park, Jong Sun; Yoon, Junghan; Lim, Do-Sun.

In: American Journal of the Medical Sciences, Vol. 346, No. 6, 01.12.2013, p. 479-485.

Research output: Contribution to journalArticle

Song, PS, Song, YB, Hahn, JY, Kim, DI, Yang, JH, Choi, SH, Choi, JH, Gwon, HC, Park, HS, Lee, S, Han, KR, Rha, S-W, Cho, BR, Park, JS, Yoon, J & Lim, D-S 2013, 'Gender differences in clinical outcomes after percutaneous coronary interventions with zotarolimus-eluting stents: Insights from the Korean endeavor registry', American Journal of the Medical Sciences, vol. 346, no. 6, pp. 479-485. https://doi.org/10.1097/MAJ.0b013e318297bd98
Song, Pil Sang ; Song, Young Bin ; Hahn, Joo Yong ; Kim, Doo Il ; Yang, Jeong Hoon ; Choi, Seung Hyuk ; Choi, Jin Ho ; Gwon, Hyeon Cheol ; Park, Hun Sik ; Lee, Sahng ; Han, Kyoo Rok ; Rha, Seung-Woon ; Cho, Byung Ryul ; Park, Jong Sun ; Yoon, Junghan ; Lim, Do-Sun. / Gender differences in clinical outcomes after percutaneous coronary interventions with zotarolimus-eluting stents : Insights from the Korean endeavor registry. In: American Journal of the Medical Sciences. 2013 ; Vol. 346, No. 6. pp. 479-485.
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abstract = "BACKGROUND:: The impact of gender on outcomes after percutaneous coronary intervention (PCI) with second-generation drug-eluting stents is not known in Asian patients. The authors studied outcomes after PCI with zotarolimus-eluting stent in unselected consecutive series of Asian patients according to gender. METHODS:: Outcomes among patients treated with zotarolimus-eluting stents from multicenter registry were evaluated by gender. The primary outcome was major adverse cardiac events, composite of cardiac death, myocardial infarction and target lesion revascularization at 1 year. RESULTS:: Of 2,840 patients, 855 (30.1{\%}) were women. Comparatively, women were older; more frequently had diabetes, hypertension, and dyslipidemia; less frequently women were current smokers, had previous myocardial infarctions and previous PCIs; were more likely to have culprit lesions in left anterior descending coronary artery; and underwent more multilesion PCIs. After adjustment for baseline differences, women were still at lower risk of major adverse cardiac events (38 [4.4{\%}] versus 137 [6.9{\%}], adjusted hazard ratio [HR]: 0.52, 95{\%} confidence interval [CI]: 0.30-0.89, P = 0.018), mainly driven by target lesion revascularization (24 [2.8{\%}] versus 106 [5.3{\%}], adjusted HR: 0.41, 95{\%} CI: 0.24-0.70, P = 0.001) at 1 year, although rates of cardiac death, myocardial infarction and stent thrombosis were similar between genders. These results were consistent after propensity score-matched population analysis (for major adverse cardiac events, adjusted HR: 0.36, 95{\%} CI: 0.18-0.69, P = 0.012; for target lesion revascularization, adjusted HR: 0.32, 95{\%} CI: 0.15-0.69, P = 0.004) and were also constant among various high-risk subgroups. CONCLUSIONS:: Despite greater baseline clinical and angiographic risk, the use of the zotarolimus-eluting stent is associated with favorable outcomes among Asian women treated with PCI.",
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T1 - Gender differences in clinical outcomes after percutaneous coronary interventions with zotarolimus-eluting stents

T2 - Insights from the Korean endeavor registry

AU - Song, Pil Sang

AU - Song, Young Bin

AU - Hahn, Joo Yong

AU - Kim, Doo Il

AU - Yang, Jeong Hoon

AU - Choi, Seung Hyuk

AU - Choi, Jin Ho

AU - Gwon, Hyeon Cheol

AU - Park, Hun Sik

AU - Lee, Sahng

AU - Han, Kyoo Rok

AU - Rha, Seung-Woon

AU - Cho, Byung Ryul

AU - Park, Jong Sun

AU - Yoon, Junghan

AU - Lim, Do-Sun

PY - 2013/12/1

Y1 - 2013/12/1

N2 - BACKGROUND:: The impact of gender on outcomes after percutaneous coronary intervention (PCI) with second-generation drug-eluting stents is not known in Asian patients. The authors studied outcomes after PCI with zotarolimus-eluting stent in unselected consecutive series of Asian patients according to gender. METHODS:: Outcomes among patients treated with zotarolimus-eluting stents from multicenter registry were evaluated by gender. The primary outcome was major adverse cardiac events, composite of cardiac death, myocardial infarction and target lesion revascularization at 1 year. RESULTS:: Of 2,840 patients, 855 (30.1%) were women. Comparatively, women were older; more frequently had diabetes, hypertension, and dyslipidemia; less frequently women were current smokers, had previous myocardial infarctions and previous PCIs; were more likely to have culprit lesions in left anterior descending coronary artery; and underwent more multilesion PCIs. After adjustment for baseline differences, women were still at lower risk of major adverse cardiac events (38 [4.4%] versus 137 [6.9%], adjusted hazard ratio [HR]: 0.52, 95% confidence interval [CI]: 0.30-0.89, P = 0.018), mainly driven by target lesion revascularization (24 [2.8%] versus 106 [5.3%], adjusted HR: 0.41, 95% CI: 0.24-0.70, P = 0.001) at 1 year, although rates of cardiac death, myocardial infarction and stent thrombosis were similar between genders. These results were consistent after propensity score-matched population analysis (for major adverse cardiac events, adjusted HR: 0.36, 95% CI: 0.18-0.69, P = 0.012; for target lesion revascularization, adjusted HR: 0.32, 95% CI: 0.15-0.69, P = 0.004) and were also constant among various high-risk subgroups. CONCLUSIONS:: Despite greater baseline clinical and angiographic risk, the use of the zotarolimus-eluting stent is associated with favorable outcomes among Asian women treated with PCI.

AB - BACKGROUND:: The impact of gender on outcomes after percutaneous coronary intervention (PCI) with second-generation drug-eluting stents is not known in Asian patients. The authors studied outcomes after PCI with zotarolimus-eluting stent in unselected consecutive series of Asian patients according to gender. METHODS:: Outcomes among patients treated with zotarolimus-eluting stents from multicenter registry were evaluated by gender. The primary outcome was major adverse cardiac events, composite of cardiac death, myocardial infarction and target lesion revascularization at 1 year. RESULTS:: Of 2,840 patients, 855 (30.1%) were women. Comparatively, women were older; more frequently had diabetes, hypertension, and dyslipidemia; less frequently women were current smokers, had previous myocardial infarctions and previous PCIs; were more likely to have culprit lesions in left anterior descending coronary artery; and underwent more multilesion PCIs. After adjustment for baseline differences, women were still at lower risk of major adverse cardiac events (38 [4.4%] versus 137 [6.9%], adjusted hazard ratio [HR]: 0.52, 95% confidence interval [CI]: 0.30-0.89, P = 0.018), mainly driven by target lesion revascularization (24 [2.8%] versus 106 [5.3%], adjusted HR: 0.41, 95% CI: 0.24-0.70, P = 0.001) at 1 year, although rates of cardiac death, myocardial infarction and stent thrombosis were similar between genders. These results were consistent after propensity score-matched population analysis (for major adverse cardiac events, adjusted HR: 0.36, 95% CI: 0.18-0.69, P = 0.012; for target lesion revascularization, adjusted HR: 0.32, 95% CI: 0.15-0.69, P = 0.004) and were also constant among various high-risk subgroups. CONCLUSIONS:: Despite greater baseline clinical and angiographic risk, the use of the zotarolimus-eluting stent is associated with favorable outcomes among Asian women treated with PCI.

KW - Drug-eluting stent

KW - Gender

KW - Percutaneous transluminal coronary angioplasty

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