title: Gender-based outcomes among patients with diabetes mellitus after percutaneous coronary intervention in the drug-eluting stent era.
abstract: Diabetes mellitus has a greater effect on mortality rates due to coronary artery disease in women than in men. Although women undergoing coronary intervention in general have a higher frequency of adverse outcomes than men, the effect of gender among diabetic patients on clinical outcomes after percutaneous coronary intervention (PCI) has not been well established in the drug-eluting stent (DES) era. We have investigated the impact of gender on long-term clinical outcome in these high risk populations. We enrolled 404 consecutive patients (74 women and 330 men) with diabetes mellitus who underwent elective PCI (85% with DES). We evaluated the incidence of major adverse cardiac events (MACE), which is a composite of total all-cause death, acute coronary syndrome (ACS), and target lesion revascularization (TLR) during a period of 4 years after coronary intervention. The women were significantly older, more likely to have dyslipidemia, and had significantly higher systolic blood pressure and LDL-C values than men. The use of insulin and angiotensin receptor blockers was more frequent among the women (32.4% versus 21.0%, P = 0.04 and 60.8% versus 39.8%, P < 0.01, respectively). The angiographic profiles of both were comparable. At four-year clinical follow-up, cumulative incidence of MACE was identical between the women and the men (16.2% versus 15.5%, P = 0.90; adjusted HR 1.23, 95% CI 0.61-2.50, P = 0.56). Although the baseline characteristics of the women were worse, clinical outcomes did not significantly differ between women and men among diabetic patients after elective PCI.
authors.affiliation: Department of Cardiovascular Medicine, Juntendo University, Tokyo, Japan.
authors.forename: Manabu
authors.initials: M
authors.lastname: Ogita
authors.forename: Katsumi
authors.initials: K
authors.lastname: Miyauchi
authors.forename: Tomotaka
authors.initials: T
authors.lastname: Dohi
authors.forename: Hideki
authors.initials: H
authors.lastname: Wada
authors.forename: Shuta
authors.initials: S
authors.lastname: Tuboi
authors.forename: Tadashi
authors.initials: T
authors.lastname: Miyazaki
authors.forename: Akihisa
authors.initials: A
authors.lastname: Nishino
authors.forename: Takayuki
authors.initials: T
authors.lastname: Yokoyama
authors.forename: Takahiko
authors.initials: T
authors.lastname: Kojima
authors.forename: Ken
authors.initials: K
authors.lastname: Yokoyama
authors.forename: Takeshi
authors.initials: T
authors.lastname: Kurata
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Daida
mesh_terms: D000368:Aged; D015906:Angioplasty, Balloon, Coronary / Q000379:methods*; D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000601:surgery*; D003920:Diabetes Mellitus / Q000453:epidemiology*; D054855:Drug-Eluting Stents; D017558:Elective Surgical Procedures / Q000379:methods; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D007564:Japan / Q000453:epidemiology; D008297:Male; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors; D017678:Sex Distribution; D012737:Sex Factors; D015996:Survival Rate / Q000639:trends; D013997:Time Factors; D016896:Treatment Outcome