title: Long-term clinical outcomes after drug eluting stent implantation in women with de novo coronary lesions. Results from the REAL (REgistro Regionale AngiopLastiche Emilia-Romagna) multicenter registry.
abstract: BACKGROUND
  The long-term effectiveness of drug eluting stents (DESs) in a real-world setting of female patients is currently unclear.
  
  
  RESULTS
  We analyzed long-term follow-up (up to 3 years) data from all female patients with de novo lesions enrolled in a prospective web-based multicenter registry (REAL Registry; study period, July 2002-June 2006) including all 15 hospitals performing PCI in the Emilia-Romagna region of Italy. Among the 3549 women without ST elevation myocardial infarction, 2434 were treated with BMSs alone and 1115 with DESs alone. At 3 years, use of DESs was associated with a lower propensity score adjusted incidence of MACE [cardiac mortality, non-fatal myocardial infarction and target vessel revascularization (TVR); 19.5% vs. 24.4%; HR 0.75, p=0.006)] and TVR (11.6% vs. 15.6%; HR 0.68, p=0.004) compared with BMSs. No difference was apparent in terms of adjusted 3-year cardiac mortality or myocardial infarction. Nevertheless, after the first 6 months of follow-up, a non significantly increased risk of myocardial infarction and stent thrombosis was found in the DES group.
  
  
  CONCLUSIONS
  In this real-world female registry, the use of DESs was associated with a 3-year reduction of TVR and MACE in comparison with the use of BMSs. However, the observed (non-significant) increment of late AMI makes performing larger studies to clarify the long-term safety of DESs mandatory.
authors.affiliation: Istituto di Cardiologia, Università di Bologna, Policlinico S. Orsola-Malpighi, Italy. paortol@tin.it
authors.forename: Paolo
authors.initials: P
authors.lastname: Ortolani
authors.forename: Emilia
authors.initials: E
authors.lastname: Solinas
authors.forename: Paolo
authors.initials: P
authors.lastname: Guastaroba
authors.forename: Gianni
authors.initials: G
authors.lastname: Casella
authors.forename: Antonio
authors.initials: A
authors.lastname: Manari
authors.forename: Giancarlo
authors.initials: G
authors.lastname: Piovaccari
authors.forename: Marco
authors.initials: M
authors.lastname: Balducelli
authors.forename: Stefano
authors.initials: S
authors.lastname: Tondi
authors.forename: Gianfranco
authors.initials: G
authors.lastname: Percoco
authors.forename: Fabio
authors.initials: F
authors.lastname: Tarantino
authors.forename: Francesco
authors.initials: F
authors.lastname: Passerini
authors.forename: Rosario
authors.initials: R
authors.lastname: Rossi
authors.forename: Luigi
authors.initials: L
authors.lastname: Vignali
authors.forename: Rossana
authors.initials: R
authors.lastname: De Palma
authors.forename: Roberto
authors.initials: R
authors.lastname: Grilli
authors.forename: Antonio
authors.initials: A
authors.lastname: Marzocchi
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015906:Angioplasty, Balloon, Coronary / Q000401:mortality*; D023903:Coronary Restenosis / Q000401:mortality; D054855:Drug-Eluting Stents / Q000009:adverse effects / Q000706:statistics & numerical data*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D007558:Italy / Q000453:epidemiology; D008875:Middle Aged; D009203:Myocardial Infarction / Q000401:mortality* / Q000628:therapy*; D016016:Proportional Hazards Models; D012042:Registries / Q000706:statistics & numerical data*; D012307:Risk Factors; D016896:Treatment Outcome