Effect of stent diameter in women undergoing percutaneous coronary intervention with early- and new-generation drug-eluting stents: From the WIN-DES collaboration.
Aged
Cause of Death
/ trends
Coronary Angiography
Drug-Eluting Stents
Female
Follow-Up Studies
Humans
Male
Myocardial Infarction
/ diagnosis
Percutaneous Coronary Intervention
/ methods
Prognosis
Prosthesis Design
Retrospective Studies
Risk Assessment
Risk Factors
Survival Rate
/ trends
Time Factors
United States
/ epidemiology
Journal
International journal of cardiology
ISSN: 1874-1754
Titre abrégé: Int J Cardiol
Pays: Netherlands
ID NLM: 8200291
Informations de publication
Date de publication:
15 07 2019
15 07 2019
Historique:
received:
04
01
2019
revised:
07
03
2019
accepted:
18
03
2019
pubmed:
16
4
2019
medline:
17
3
2020
entrez:
16
4
2019
Statut:
ppublish
Résumé
The risk of stent thrombosis (ST) or target lesion revascularization (TLR) is increased with smaller stent diameters (SD). Whether SD has a deleterious effect in women treated with early- vs. new-generation drug-eluting stents (DES) is unknown. We pooled patient-level data from 26 randomized control trials of DES. Only women treated with DES were included. Subjects were stratified according to SD: small, SD ≤ 2.75 mm; intermediate, 2.75 mm < SD ≤ 3.25 mm; and large, SD ≥ 3.25 mm. Endpoints of interest were 3-year definite ST, TLR, major adverse cardiac events (MACE: the composite of death, myocardial infarction or TLR) and death. Of 6413 women, 2274 (35.0%) had a small SD, 2448 (38.0%) had an intermediate SD, and 1691 (26.0%) had a large SD. By multivariable analysis, stent diameter (per 0.25 mm decrease) was associated with an increased risk of TLR and ST, which was uniform in terms of magnitude and direction between early- and new-generation DES. There were no differences in MACE or death across groups. Small SD in women undergoing PCI is associated with an increased risk of definite ST and TLR, consistently with both early- and new-generation DES.
Sections du résumé
BACKGROUND
The risk of stent thrombosis (ST) or target lesion revascularization (TLR) is increased with smaller stent diameters (SD). Whether SD has a deleterious effect in women treated with early- vs. new-generation drug-eluting stents (DES) is unknown.
METHODS
We pooled patient-level data from 26 randomized control trials of DES. Only women treated with DES were included. Subjects were stratified according to SD: small, SD ≤ 2.75 mm; intermediate, 2.75 mm < SD ≤ 3.25 mm; and large, SD ≥ 3.25 mm. Endpoints of interest were 3-year definite ST, TLR, major adverse cardiac events (MACE: the composite of death, myocardial infarction or TLR) and death.
RESULTS
Of 6413 women, 2274 (35.0%) had a small SD, 2448 (38.0%) had an intermediate SD, and 1691 (26.0%) had a large SD. By multivariable analysis, stent diameter (per 0.25 mm decrease) was associated with an increased risk of TLR and ST, which was uniform in terms of magnitude and direction between early- and new-generation DES. There were no differences in MACE or death across groups.
CONCLUSION
Small SD in women undergoing PCI is associated with an increased risk of definite ST and TLR, consistently with both early- and new-generation DES.
Identifiants
pubmed: 30982549
pii: S0167-5273(19)30055-5
doi: 10.1016/j.ijcard.2019.03.034
pii:
doi:
Types de publication
Journal Article
Multicenter Study
Randomized Controlled Trial
Langues
eng
Sous-ensembles de citation
IM
Pagination
59-61Informations de copyright
Copyright © 2019 Elsevier B.V. All rights reserved.