title: Sex differences in neointimal hyperplasia following endeavor zotarolimus-eluting stent implantation.
abstract: Inconsistent results in outcomes have been observed between the genders after drug-eluting stent implantation. The aim of this study was to investigate gender differences in neointimal proliferation for the Endeavor zotarolimus-eluting stent (ZES) and the Driver bare-metal stent (BMS). A total of 476 (n = 391 ZES, n = 85 BMS) patients whose volumetric intravascular ultrasound analyses were available at 8-month follow-up were studied. At 8 months, neointimal obstruction and maximum cross-sectional narrowing (CSN) were significantly lower in women than in men receiving ZES (neointimal obstruction 15.5 ± 9.5% vs 18.2 ± 10.9%, p = 0.025; maximum CSN 30.3 ± 13.2% vs 34.8 ± 15.0%, p = 0.007). Conversely, these parameters tended to be higher in women than in men receiving BMS (neointimal obstruction 36.3 ± 15.9% vs 27.5 ± 17.2%, p = 0.053; maximum CSN 54.3 ± 18.6% vs 45.6 ± 18.3%, p = 0.080). There was a significant interaction between stent type and gender regarding neointimal obstruction (p = 0.001) and maximum CSN (p = 0.003). Multivariate linear regression analysis revealed that female gender was independently associated with lower neointimal obstruction (p = 0.027) and maximum CSN (p = 0.004) for ZES but not for BMS. Compared to BMS, ZES were independently associated with a reduced risk for binary restenosis in both genders (odds ratio for women 0.003, p = 0.001; odds ratio for men 0.191, p <0.001), but the magnitude of this risk reduction with ZES was significantly greater in women than men (p = 0.015). In conclusion, female gender is independently associated with decreased neointimal hyperplasia in patients treated with ZES. The magnitude of risk reduction for binary restenosis with ZES is significantly greater in women than in men.
authors.affiliation: Center for Cardiovascular Technology, Stanford University, California, USA.
authors.forename: Daisaku
authors.initials: D
authors.lastname: Nakatani
authors.forename: Junya
authors.initials: J
authors.lastname: Ako
authors.forename: Jennifer A
authors.initials: JA
authors.lastname: Tremmel
authors.forename: Katsuhisa
authors.initials: K
authors.lastname: Waseda
authors.forename: Hiromasa
authors.initials: H
authors.lastname: Otake
authors.forename: Bon-Kwon
authors.initials: BK
authors.lastname: Koo
authors.forename: Akiyoshi
authors.initials: A
authors.lastname: Miyazawa
authors.forename: Yoichiro
authors.initials: Y
authors.lastname: Hongo
authors.forename: Seung-Ho
authors.initials: SH
authors.lastname: Hur
authors.forename: Ryota
authors.initials: R
authors.lastname: Sakurai
authors.forename: Paul G
authors.initials: PG
authors.lastname: Yock
authors.forename: Yasuhiro
authors.initials: Y
authors.lastname: Honda
authors.forename: Peter J
authors.initials: PJ
authors.lastname: Fitzgerald
mesh_terms: D015906:Angioplasty, Balloon, Coronary / Q000295:instrumentation*; D002140:California / Q000453:epidemiology; D023903:Coronary Restenosis / Q000453:epidemiology* / Q000209:etiology / Q000473:pathology; D054855:Drug-Eluting Stents; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006965:Hyperplasia / Q000453:epidemiology / Q000209:etiology / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000601:surgery*; D058426:Neointima / Q000473:pathology*; D011379:Prognosis; D011474:Prosthesis Design; D012189:Retrospective Studies; D012307:Risk Factors; D017678:Sex Distribution; D012737:Sex Factors; D020123:Sirolimus / Q000031:analogs & derivatives* / Q000494:pharmacology
chemical_list: C489443:zotarolimus; D020123:Sirolimus