Gender and restenosis after coronary artery stenting.
OBJECTIVE
To examine the impact of sex on restenosis in a large cohort of consecutive patients undergoing coronary stenting and systematic angiographic and clinical follow-up.


RESULTS
The study includes a cohort of 4374 consecutive patients (1025 women and 3349 men), undergoing coronary stenting for stable or unstable angina. Follow-up angiography at 6 months was performed in 80% of patients. Clinical events were assessed for a period of 1 year after the procedure. Main end-points of the study were angiographic and clinical restenosis at follow-up. Compared to men, women were older, presented more often with diabetes, smaller vessel size and shorter lesions. Clinical restenosis (need for reintervention) was found in 14.8% of women and 17.5% of men (P=0.048). The incidence of angiographic restenosis was significantly lower in women then in men (28.9% vs 33.9%, respectively, P=0.01). After adjustment for other covariates, women presented a 23% reduction of the risk of restenosis: odds ratio 0.77 (95% confidence interval 0.63 to 0.93). While a small vessel size was a risk factor for restenosis in both sexes, the influence of diabetes on restenosis was mostly confined to women.


CONCLUSIONS
Compared with men, women present a lower risk of restenosis after coronary stenting despite a more preponderant presence of two major risk factors for restenosis, diabetes and small vessel size. There are sex-based differences in predictive factors of restenosis with diabetes having a particularly strong impact in women.
Mehilli
Julinda
J
Medizinische Klinik rechts der Isar der Technischen Universität, Munich, Germany.
Kastrati
Adnan
A
Bollwein
Hildegard
H
Dibra
Alban
A
Schühlen
Helmut
H
Dirschinger
Josef
J
Schömig
Albert
A
D000367:Age Factors; D000368:Aged; D000787:Angina Pectoris / Q000188:drug therapy / Q000601:surgery; D017023:Coronary Angiography; D023903:Coronary Restenosis / Q000209:etiology; D023921:Coronary Stenosis / Q000188:drug therapy / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D012044:Regression Analysis; D012307:Risk Factors; D012737:Sex Factors; D015607:Stents; D016896:Treatment Outcome