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Sex-related impact on clinical outcomes of patients treated with drug-eluting stents according to clinical presentation: Patient-level pooled analysis from the GRAND-DES registry.
Shin, Eun-Seok; Jun, Eun Jung; Han, Jung-Kyu; Kong, Min Gyu; Kang, Jeehoon; Zheng, Chengbin; Garg, Scot; Choi, Young Jin; Bae, Jang-Whan; Chun, Kook-Jin; Kim, Doo-Il; Rha, Seung-Woon; Lee, Sung Yun; Rhew, Jay Young; Woo, Seong-Ill; Lee, Han Cheol; Jeong, Jin-Ok; Yang, Han-Mo; Park, Kyung Woo; Kang, Hyun-Jae; Koo, Bon-Kwon; Chae, In-Ho; Kim, Hyo-Soo.
Afiliação
  • Shin ES; Department of Cardiology, Ulsan Hospital, Ulsan, Korea; Department of Cardiology, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Korea.
  • Jun EJ; Department of Cardiology, Ulsan Hospital, Ulsan, Korea; Department of Cardiology, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Korea.
  • Han JK; Cardiovascular Center, Seoul National University Hospital, Seoul, Republic of Korea.
  • Kong MG; Cardiovascular Center, Seoul National University Hospital, Seoul, Republic of Korea.
  • Kang J; Cardiovascular Center, Seoul National University Hospital, Seoul, Republic of Korea.
  • Zheng C; Cardiovascular Center, Seoul National University Hospital, Seoul, Republic of Korea.
  • Garg S; East Lancashire Hospitals NHS Trust, Blackburn, Lancashire, United Kingdom.
  • Choi YJ; Division of Cardiology, Department of Internal Medicine, Sejong General Hospital, Bucheon, Republic of Korea.
  • Bae JW; Division of Cardiology, Department of Internal Medicine, Chungbuk National University College of Medicine, Cheongju, Republic of Korea.
  • Chun KJ; Division of Cardiology, Department of Internal Medicine, Pusan National University Yangsan Hospital, Yangsan, Republic of Korea.
  • Kim DI; Department of Internal Medicine, Haeundae Paik Hospital, Inje University College of Medicine, Busan, Republic of Korea.
  • Rha SW; Cardiovascular Center, Korea University Guro Hospital, Seoul, Republic of Korea.
  • Lee SY; Division of Cardiology, Department of Internal Medicine, Inje University Ilsan Paik Hospital, Goyang, Republic of Korea.
  • Rhew JY; Department of Internal Medicine and Cardiovascular Center, Presbyterian Medical Center, Jeonju, Republic of Korea.
  • Woo SI; Division of Cardiology, Department of Internal Medicine, Inha University Hospital, Incheon, Republic of Korea.
  • Lee HC; Division of Cardiology, Department of Internal Medicine, Pusan National University Hospital, Busan, Republic of Korea.
  • Jeong JO; Division of Cardiology, Department of Internal Medicine, Chungnam National University School of Medicine, Daejon, Republic of Korea.
  • Yang HM; Cardiovascular Center, Seoul National University Hospital, Seoul, Republic of Korea.
  • Park KW; Cardiovascular Center, Seoul National University Hospital, Seoul, Republic of Korea.
  • Kang HJ; Cardiovascular Center, Seoul National University Hospital, Seoul, Republic of Korea.
  • Koo BK; Cardiovascular Center, Seoul National University Hospital, Seoul, Republic of Korea.
  • Chae IH; Cardiovascular Center, Seoul National University Bundang Hospital, Seongnam-si, Republic of Korea.
  • Kim HS; Cardiovascular Center, Seoul National University Hospital, Seoul, Republic of Korea. hyosoo@snu.ac.kr.
Cardiol J ; 30(1): 105-116, 2023.
Article em En | MEDLINE | ID: mdl-33634845
ABSTRACT

BACKGROUND:

The contribution of sex and initial clinical presentation to the long-term outcomes in patients undergoing percutaneous coronary intervention (PCI) is still debated.

METHODS:

Individual patient data from 5 Korean-multicenter drug-eluting stent (DES) registries (The GRAND-DES) were pooled. A total of 17,286 patients completed 3-year follow-up (5216 women and 12,070 men). The median follow-up duration was 1125 days (interquartile range 1097-1140 days), and the primary endpoint was cardiac death at 3 years.

RESULTS:

The clinical indication for PCI was stable angina pectoris (SAP) in 36.8%, unstable angina pectoris (UAP) or non-ST-segment elevation myocardial infarction (NSTEMI) in 47.4%, and ST-segment elevation myocardial (STEMI) in 15.8%. In all groups, women were older and had a higher proportion of hypertension and diabetes mellitus compared with men. Women presenting with STEMI were older than women with SAP, with the opposite seen in men. There was no sex difference in cardiac death for SAP or UAP/NSTEMI. In STEMI patients, the incidence of cardiac death (7.9% vs. 4.4%, p = 0.001), all-cause mortality (11.1% vs. 6.9%, p = 0.001), and minor bleeding (2.2% vs. 1.2%, p = 0.043) was significantly higher in women. After multivariable adjustment, cardiac death was lower in women for UAP/NSTEMI (HR 0.69, 95% CI 0.53-0.89, p = 0.005), while it was similar for STEMI (HR 0.97, 95% CI 0.65-1.44, p = 0.884).

CONCLUSIONS:

There was no sex difference in cardiac death after PCI with DES for SAP and UAP/NSTEMI patients. In STEMI patients, women had worse outcomes compared with men; however, after the adjustment of confounders, female sex was not an independent predictor of mortality.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Stents Farmacológicos / Angina Estável / Intervenção Coronária Percutânea / Infarto do Miocárdio sem Supradesnível do Segmento ST / Infarto do Miocárdio com Supradesnível do Segmento ST / Infarto do Miocárdio Tipo de estudo: Prognostic_studies Limite: Female / Humans / Male Idioma: En Ano de publicação: 2023 Tipo de documento: Article

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Stents Farmacológicos / Angina Estável / Intervenção Coronária Percutânea / Infarto do Miocárdio sem Supradesnível do Segmento ST / Infarto do Miocárdio com Supradesnível do Segmento ST / Infarto do Miocárdio Tipo de estudo: Prognostic_studies Limite: Female / Humans / Male Idioma: En Ano de publicação: 2023 Tipo de documento: Article