Short- and long-term outcomes of coronary stenting in women versus men: results from the National Cardiovascular Data Registry Centers for Medicare & Medicaid services cohort.
Circulation
; 126(18): 2190-9, 2012 Oct 30.
Article
em En
| MEDLINE
| ID: mdl-22988009
ABSTRACT
BACKGROUND:
Conflicting evidence exists on sex-based outcomes after coronary stenting. METHODS ANDRESULTS:
Data on 426 996 patients ≥65 years old (42.3% women) from the National Cardiovascular Data Registry CathPCI Registry (2004-2008) were linked to Medicare inpatient claims to compare in-hospital outcomes by sex and long-term outcomes by sex and stent type. In-hospital complications were more frequent in women than in men death (3869 [2.2%] versus 3737 [1.6%]; adjusted odds ratio, 1.41; 95% confidence interval [CI], 1.33-1.49), myocardial infarction (2365 [1.3%] versus 2858 [1.2%]; odds ratio, 1.19; 95% CI, 1.11-1.27), bleeding (7860 [4.4%] versus 5627 [2.3%]; odds ratio, 1.86; 95% CI, 1.79-1.93), and vascular complications (2381 [1.3%] versus 1648 [0.7%]; odds ratio, 1.85; 95% CI, 1.73-1.99). At 20.4 months, women had a lower adjusted risk of death (hazard ratio [HR], 0.92; 95% CI, 0.90-0.94) but similar rates of myocardial infarction, revascularization, and bleeding. Relative to bare metal stent use, drug-eluting stent use was associated with similar improved long-term outcomes in both sexes death (women adjusted HR, 0.78; 95% CI, 0.76-0.81; men HR, 0.77; 95% CI, 0.74-0.79), myocardial infarction (women HR, 0.79; 95% CI, 0.74-0.84; men HR, 0.81; 95% CI, 0.77-0.85), and revascularization (women HR, 0.93; 95% CI, 0.90-0.97; men HR, 0.91; 95% CI, 0.88-0.94). There was no interaction between sex and stent type for long-term outcomes.CONCLUSIONS:
In contemporary coronary stenting, women have a slightly higher procedural risk than men but have better long-term survival. In both sexes, use of a drug-eluting stent is associated with lower long-term likelihood for death, myocardial infarction, and revascularization.
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Stents
/
Fatores Sexuais
/
Medicare
/
Medicaid
/
Doença das Coronárias
Tipo de estudo:
Etiology_studies
/
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Limite:
Aged
/
Aged80
/
Female
/
Humans
/
Male
País/Região como assunto:
America do norte
Idioma:
En
Revista:
Circulation
Ano de publicação:
2012
Tipo de documento:
Article
País de afiliação:
Estados Unidos