Short- and Long-Term Outcomes of Coronary Stenting in Women Versus Men

Anderson, Monique; Peterson, Eric D.; Brennan, James M.; Rao, Sunil V.; Dai, David; Anstrom, Kevin J.; Piana, Robert N.; Popescu, Ana Maria; Sedrakyan, Art; Messenger, John C.; Douglas, Pamela S.

doi:10.1161/circulationaha.112.111369

Cited by 77 publications

(15 citation statements)

References 44 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In agreement with previous studies [ 1 , 4 , 28 – 31 ], female post-infarction patients included in our prospective cohort study had a significantly higher mortality risk compared to males. Our data agree with previous explanations of this difference by female patients being older [ 4 – 7 ], having a higher prevalence of comorbidities such as hypertension and diabetes [ 4 – 6 , 8 ] and of non-obstructive CAD [ 12 – 16 ], being subject to a less invasive diagnostic [ 6 , 32 ] or therapeutic approach [ 6 , 33 – 36 ] as well as by the composite of different variables [ 37 ].…”

Section: Discussionsupporting

confidence: 93%

Sex differences in long-term mortality among acute myocardial infarction patients: Results from the ISAR-RISK and ART studies

et al. 2017

View full text Add to dashboard Cite

BackgroundMortality rates in females who survived acute myocardial infarction (AMI) exceed those in males. Differences between sexes in age, cardiovascular risk factors and revascularization therapy have been proposed as possible reasons.ObjectiveTo select sets of female and male patients comparable in respect of relevant risk factors in order to compare the sex-specific risk in a systematic manner.MethodsData of the ISAR-RISK and ART studies were investigated. Patients were enrolled between 1996 and 2005 and suffered from AMI within 4 weeks prior to enrolment. Patients of each sex were selected with 1:1 equivalent age, previous AMI history, sinus-rhythm presence, hypertension, diabetes mellitus, smoking status, left ventricular ejection fraction (LVEF), and revascularization therapy. Survival times were compared between sex groups in the whole study cohort and in the matched cohort.ResultsOf 3840 consecutive AMI survivors, 994 (25.9%) were females and 2846 (74.1%) were males. Females were older and suffered more frequently from hypertension and diabetes mellitus. In the whole cohort, females showed an increased mortality with a hazard ratio (HR) of 1.54 compared to males (p<0.0001). The matched cohort comprised 802 patients of each sex and revealed a trend towards poorer survival in females (HR for female sex 1.14; p = 0.359). However, significant mortality differences with a higher risk in matched females was observed during the first year after AMI (HR = 1.61; p = 0.045) but not during the subsequent years.ConclusionMatched sub-groups of post-AMI patients showed a comparable long-term mortality. However, a female excess mortality remained during first year after AMI and cannot be explained by differences in age, cardiovascular risk factors, and modes of acute treatment. Other causal factors, including clinical as well as psychological and social aspects, need to be considered. Female post-AMI patients should be followed more actively particularly during the first year after AMI.

show abstract

Section: Discussionsupporting

confidence: 93%

Sex differences in long-term mortality among acute myocardial infarction patients: Results from the ISAR-RISK and ART studies

et al. 2017

View full text Add to dashboard Cite

show abstract

“…A large study examining sex-based differences in outcomes by stent type among Medicare beneficiaries has shown that while women have higher pre-procedural risk compared with men, they have higher long-term survival. 16 The use of DES was associated with significant reductions in long-term death, MI, or revascularization. In the context of these data, our findings may reflect disparities in the use of proven secondary prevention strategies between males and females.…”

Section: Discussionmentioning

confidence: 98%

Temporal trends in percutaneous coronary intervention outcomes among older patients in the United States

Rao¹,

Hess²,

Dai³

et al. 2013

American Heart Journal

Self Cite

View full text Add to dashboard Cite

Background New percutaneous coronary intervention (PCI) device technologies are often rapidly adopted into clinical practice, yet few studies have examined the overall impact of these new technologies on patient outcomes in community practice. Methods In hopes of determining temporal trends in PCI outcomes, we used data from the Centers for Medicare & Medicaid Service's Chronic Condition Warehouse (n = 3,250,836) by comparing patient characteristics and rates of 3-year major adverse cardiac events (MACE) across the balloon angioplasty (POBA) era (01/1991-09/1995), the bare metal stent (BMS) era (02/1998-04/2003), and the drug-eluting stent (DES) era (05/2004-10/2006). The adjusted association between era and outcomes was determined with Cox proportional hazards modeling (POBA era as reference). Results Compared with the POBA era, patients undergoing PCI were significantly older and had more medical comorbidities, and the risk for 3-year MACE was significantly lower during the BMS and DES eras (BMS vs. POBA adjusted HR [95% CI]: 0.930 [0.926–0.935]; DES vs. BMS: 0.831 [0.827–0.835]). Compared with males, the adjusted risk for 3-year MACE among females was lower during the POBA era, but slightly higher during the BMS and DES eras. Across all three eras, patients ≥75 years of age had higher adjusted risk for MACE compared with younger patients, and the risk for revascularization was lower for both females and older patients. Conclusions Despite its application in older and sicker Medicare beneficiaries, there has been a significant decrease in post-PCI MACE over time. The risk for death or myocardial infarction is higher among females and older patients compared with males and younger patients; therefore, future studies should focus on improving clinical outcomes in these high-risk subgroups.

show abstract

“…Child-Pugh class C and the amount of intraoperative FFP, which represent poor recipient liver function and have been associated with poor recipient outcome [24] , [25] , can reasonably be associated with early reoperation after liver transplantation, although, to the best of our knowledge, this is the first report demonstrating a higher early reoperation rate in more seriously ill recipients. Although there is no previous reports supporting the reason for female sex as a predictive risk factors of reoperation in liver transplantation, in the setting of coronary stenting, there is the preponderance of evidence supporting that female had increased risk of in-hospital death and complications [26] , [27] . One possible reason in our study is that female recipient has significant smaller body and graft size in comparison with male (body height; female vs male, 156.6 [7.1] cm vs 170.5 [5.9] cm, p<0.01, body weight; 52.8 [8.4] kg vs 69.1 [9.9] kg, p<0.01, and graft size; 486.6 [127.7] g vs 579.4 [105.0] g, p<0.01), which might indicate the possible technical complications in smaller vessel reconstructions as reported in liver transplantation in children [28] .…”

Section: Discussionmentioning

confidence: 99%

Impact of Early Reoperation following Living-Donor Liver Transplantation on Graft Survival

et al. 2014

View full text Add to dashboard Cite

BackgroundThe reoperation rate remains high after liver transplantation and the impact of reoperation on graft and recipient outcome is unclear. The aim of our study is to evaluate the impact of early reoperation following living-donor liver transplantation (LDLT) on graft and recipient survival.MethodsRecipients that underwent LDLT (n = 111) at the University of Tokyo Hospital between January 2007 and December 2012 were divided into two groups, a reoperation group (n = 27) and a non-reoperation group (n = 84), and case-control study was conducted.ResultsEarly reoperation was performed in 27 recipients (24.3%). Mean time [standard deviation] from LDLT to reoperation was 10 [9.4] days. Female sex, Child-Pugh class C, Non-HCV etiology, fulminant hepatitis, and the amount of intraoperative fresh frozen plasma administered were identified as possibly predictive variables, among which females and the amount of FFP were identified as independent risk factors for early reoperation by multivariable analysis. The 3-, and 6- month graft survival rates were 88.9% (95%confidential intervals [CI], 70.7–96.4), and 85.2% (95%CI, 66.5–94.3), respectively, in the reoperation group (n = 27), and 95.2% (95%CI, 88.0–98.2), and 92.9% (95%CI, 85.0–96.8), respectively, in the non-reoperation group (n = 84) (the log-rank test, p = 0.31). The 12- and 36- month overall survival rates were 96.3% (95%CI, 77.9–99.5), and 88.3% (95%CI, 69.3–96.2), respectively, in the reoperation group, and 89.3% (95%CI, 80.7–94.3) and 88.0% (95%CI, 79.2–93.4), respectively, in the non-reoperation group (the log-rank test, p = 0.59).ConclusionsObserved graft survival for the recipients who underwent reoperation was lower compared to those who did not undergo reoperation, though the result was not significantly different. Recipient overall survival with reoperation was comparable to that without reoperation. The present findings enhance the importance of vigilant surveillance for postoperative complication and surgical rescue at an early postoperative stage in the LDLT setting.

show abstract

Short- and Long-Term Outcomes of Coronary Stenting in Women Versus Men

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

Cited by 77 publications

References 44 publications

Sex differences in long-term mortality among acute myocardial infarction patients: Results from the ISAR-RISK and ART studies

Sex differences in long-term mortality among acute myocardial infarction patients: Results from the ISAR-RISK and ART studies

Temporal trends in percutaneous coronary intervention outcomes among older patients in the United States

Impact of Early Reoperation following Living-Donor Liver Transplantation on Graft Survival

Contact Info

Product

Resources

About