Comparisons of the uptake and in-hospital outcomes associated with second-generation drug-eluting stents between men and women: results from the CathPCI Registry.
OBJECTIVE
We sought to examine trends in use and outcomes of second-generation drug-eluting stents (DES) across sexes in a contemporary percutaneous coronary intervention (PCI) cohort.


BACKGROUND
Sparse female enrollment in trials comparing first-generation versus second-generation DES may influence clinical decision making at the time of PCI.


METHODS
We studied patients undergoing PCI with DES enrolled in the CathPCI Registry between July 2009 and March 2013. We compared the prevalence of second-generation DES use by sex over time. Outcomes included procedural success, post-PCI bleeding, and vascular complications. Associations between sex and DES type on outcomes were assessed using logistic regression with formal interaction tests.


RESULTS
Compared with men (n=1 129 122; 67.7%), women (n=538 835; 32.3%) were older, with a higher prevalence of diabetes mellitus, peripheral vascular, and chronic kidney disease. Although use of second-generation DES increased among both men and women over time, use was higher among men in the first 1.5 years, with no differences thereafter. There were no differences in procedural success, bleeding, or vascular complications across sexes between first-generation and second-generation DES.


CONCLUSIONS
Uptake of second-generation DES increased over time in women, with comparable in-hospital benefits as first-generation DES across sexes.
aInterventional Cardiovascular Research and Clinical Trials, The Icahn School of Medicine at Mount Sinai, New York, New York bDuke Clinical Research Institute, Durham, North Carolina cHeart Hospital, The Detroit Medical Center, Detroit, Michigan dDepartment of Medicine, Mayo Clinic, Rochester, Minnesota eGeisinger Center for Health Research, Danville, Pennsylvania, USA fInterventional Cardiology Unit, San Raffaele Scientific Institute, Milan, Italy gDeutsches Zentrum für Herz Kreislaufforschung, partner site Munich Heart Alliance, Munich, Germany.
Usman
U
Baber
Gennaro
G
Giustino
Tracy
T
Wang
Cindy
C
Grines
Lisa A
LA
McCoy
Paramita
P
Saha-Chaudhuri
Patricia
P
Best
Kimberly A
KA
Skelding
Rebecca
R
Ortega
Alaide
A
Chieffo
Julinda
J
Mehilli
James
J
Tcheng
Roxana
R
Mehran
D000368:Aged; D016009:Chi-Square Distribution; D015897:Comorbidity; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000628:therapy*; D054855:Drug-Eluting Stents / Q000639:trends; D005260:Female; D054625:Healthcare Disparities / Q000639:trends; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D062645:Percutaneous Coronary Intervention / Q000009:adverse effects / Q000295:instrumentation* / Q000639:trends; D010818:Practice Patterns, Physicians' / Q000639:trends; D015995:Prevalence; D011474:Prosthesis Design; D012042:Registries; D012307:Risk Factors; D012737:Sex Factors; D016896:Treatment Outcome; D014481:United States / Q000453:epidemiology