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

Monique L. Anderson, Eric D. Peterson, J. Matthew Brennan, Sunil V. Rao, David Dai, Kevin J. Anstrom, Robert Piana, Andra Popescu, Art Sedrakyan, John C. Messenger, Pamela S. Douglas

Research output: Contribution to journalArticlepeer-review

Abstract

Background-Conflicting evidence exists on sex-based outcomes after coronary stenting. Methods and Results-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.

Original languageEnglish (US)
Pages (from-to)2190-2199
Number of pages10
JournalCirculation
Volume126
Issue number18
DOIs
StatePublished - Oct 30 2012
Externally publishedYes

Keywords

  • bare metal stents
  • coronary disease
  • drug-eluting stents
  • proportional hazards models
  • sex factors

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Physiology (medical)

Fingerprint

Dive into the research topics of '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'. Together they form a unique fingerprint.

Cite this