Results of coronary artery stenting in women versus men: a single center experience.
BACKGROUND
Prior studies have suggested that women are at higher risk for morbidity and mortality during coronary angioplasty, although long-term prognosis is similar after successful procedures.


OBJECTIVE
To examine the role of gender in coronary stenting, including immediate procedural success as well as early and late outcomes.


METHODS
The study group comprised 560 consecutive patients (119 women and 441 men) who had undergone stenting over a 3 year period.


RESULTS
The indications for coronary stenting were similar among women and men, and stents were successfully deployed at similar rates without complications (92 vs. 90% respectively). Cardiac death or myocardial infarction within 30 days of the procedure was observed in 5% of women and men, whereas none of the women, compared to 1.4% of men, had early revascularization. Bleeding complications occurred in 4% of women and 2% of men. During 10 +/- 2.8 months of follow-up, 58% of women and men underwent repeat cardiac catheterization, revealing similar rates of restenosis, 36 vs. 32% respectively. During the study period, 3.3% of women as compared to 0.9% of men had a cardiac death (not significant). Cardiac death or myocardial infarction was observed in 7% of women and 8% of men, and the combined endpoint of death, myocardial infarction or revascularization, was noted in 24% and 26% respectively. Multivariate Cox analyses of the clinical, angiographic and procedural characteristics revealed that multiple stent deployment was the only predictor of major adverse cardiac event among men, whereas none of these characteristics predicted outcome in women.


CONCLUSIONS
Coronary stenting is performed with similar success rates among women and men, with similar restenosis rates as well as early and late major adverse cardiac events.
Moriel
Mady
M
Jesselson Heart Center, Dept. of Cardiology, Shaare Zedek Medical Center, P.O. Box 3235, Jerusalem 91031, Israel. cardio@szmc.org.il
Feld
Steven
S
Almagor
Yaron
Y
Balkin
Jonathan A
JA
Klutstein
Marc W
MW
Meerkin
David
D
Rosenmann
David
D
Winkler
Hadar
H
Tzivoni
Dan
D
D000368:Aged; D000704:Analysis of Variance; D015906:Angioplasty, Balloon, Coronary / Q000009:adverse effects / Q000379:methods; D017023:Coronary Angiography; D003327:Coronary Disease / Q000000981:diagnostic imaging / Q000401:mortality / Q000628:therapy*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007557:Israel / Q000453:epidemiology; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009017:Morbidity; D009203:Myocardial Infarction / Q000209:etiology; D018579:Patient Selection; D019106:Postoperative Hemorrhage / Q000209:etiology; D011237:Predictive Value of Tests; D011379:Prognosis; D016016:Proportional Hazards Models; D012008:Recurrence; D012307:Risk Factors; D012727:Sex Characteristics; D017678:Sex Distribution; D012737:Sex Factors; D015607:Stents / Q000009:adverse effects; D016896:Treatment Outcome