title: Short- and long-term outcomes of coronary stenting in women versus men: results from the National Cardiovascular Data Registry Centers for Medicare & Medicaid services cohort.
abstract: BACKGROUND
  Conflicting evidence exists on sex-based outcomes after coronary stenting.
  
  
  RESULTS
  Data on 426 996 patients ≥65 years old (42.3% women) from the National Cardiovascular Data Registry CathPCI Registry (2004-2008) were linked to Medicare inpatient claims to compare in-hospital outcomes by sex and long-term outcomes by sex and stent type. In-hospital complications were more frequent in women than in men: death (3869 [2.2%] versus 3737 [1.6%]; adjusted odds ratio, 1.41; 95% confidence interval [CI], 1.33-1.49), myocardial infarction (2365 [1.3%] versus 2858 [1.2%]; odds ratio, 1.19; 95% CI, 1.11-1.27), bleeding (7860 [4.4%] versus 5627 [2.3%]; odds ratio, 1.86; 95% CI, 1.79-1.93), and vascular complications (2381 [1.3%] versus 1648 [0.7%]; odds ratio, 1.85; 95% CI, 1.73-1.99). At 20.4 months, women had a lower adjusted risk of death (hazard ratio [HR], 0.92; 95% CI, 0.90-0.94) but similar rates of myocardial infarction, revascularization, and bleeding. Relative to bare metal stent use, drug-eluting stent use was associated with similar improved long-term outcomes in both sexes: death (women: adjusted HR, 0.78; 95% CI, 0.76-0.81; men: HR, 0.77; 95% CI, 0.74-0.79), myocardial infarction (women: HR, 0.79; 95% CI, 0.74-0.84; men: HR, 0.81; 95% CI, 0.77-0.85), and revascularization (women: HR, 0.93; 95% CI, 0.90-0.97; men: HR, 0.91; 95% CI, 0.88-0.94). There was no interaction between sex and stent type for long-term outcomes.
  
  
  CONCLUSIONS
  In contemporary coronary stenting, women have a slightly higher procedural risk than men but have better long-term survival. In both sexes, use of a drug-eluting stent is associated with lower long-term likelihood for death, myocardial infarction, and revascularization.
authors.affiliation: 7022 N Pavilion DUMC, PO Box 17969, Durham, NC 27715, USA. monique.anderson@duke.edu
authors.forename: Monique L
authors.initials: ML
authors.lastname: Anderson
authors.forename: Eric D
authors.initials: ED
authors.lastname: Peterson
authors.forename: J Matthew
authors.initials: JM
authors.lastname: Brennan
authors.forename: Sunil V
authors.initials: SV
authors.lastname: Rao
authors.forename: David
authors.initials: D
authors.lastname: Dai
authors.forename: Kevin J
authors.initials: KJ
authors.lastname: Anstrom
authors.forename: Robert
authors.initials: R
authors.lastname: Piana
authors.forename: Andra
authors.initials: A
authors.lastname: Popescu
authors.forename: Art
authors.initials: A
authors.lastname: Sedrakyan
authors.forename: John C
authors.initials: JC
authors.lastname: Messenger
authors.forename: Pamela S
authors.initials: PS
authors.lastname: Douglas
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015906:Angioplasty, Balloon, Coronary / Q000706:statistics & numerical data; D000925:Anticoagulants / Q000627:therapeutic use; D002317:Cardiovascular Agents / Q000627:therapeutic use; D003131:Combined Modality Therapy; D001026:Coronary Artery Bypass / Q000706:statistics & numerical data; D003327:Coronary Disease / Q000188:drug therapy / Q000401:mortality / Q000601:surgery / Q000628:therapy*; D054855:Drug-Eluting Stents / Q000706:statistics & numerical data; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007297:Inpatients / Q000706:statistics & numerical data; D053208:Kaplan-Meier Estimate; D008297:Male; D008484:Medicaid / Q000706:statistics & numerical data*; D006278:Medicare / Q000706:statistics & numerical data*; D016017:Odds Ratio; D011183:Postoperative Complications / Q000401:mortality; D016016:Proportional Hazards Models; D012042:Registries; D012306:Risk; D012737:Sex Factors; D015607:Stents / Q000706:statistics & numerical data*; D016896:Treatment Outcome; D014481:United States / Q000453:epidemiology
chemical_list: D000925:Anticoagulants; D002317:Cardiovascular Agents