Impact of gender and age on 3-year clinical outcome and chest pain of patients with coronary artery disease treated with contemporary drug-eluting stents: A patient-level pooled analysis

  • M. K
  • L. V
  • M. L
  • et al.
ISSN: 1558-3597
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Abstract

BACKGROUND Women report more often chest pain following percutaneous coronary intervention (PCI), yet little is known about the impact of age on these symptoms. We aimed to assess age and gender-related differences in chest pain following PCI with newergeneration drug-eluting stents (DES). METHODS A patient-level pooled analysis of the TWENTE and DUTCH PEERS randomized trials (NCT01066650; NCT01331707) was performed, in which patients were treated with newer generation permanent polymer DES. The primary endpoint of both studies was target vessel failure (TVF); secondary endpoints included MACE (composite of any death, any myocardial infarction (MI), emergent CABG or target lesion revascularization) and POCE (composite of any death, any MI and any revascularization). RESULTS Clinical follow-up was available in 3,188 patients (99.8%). Women had more risk factors including diabetes (24.2% vs. 17.8%, p<0.001), hypertension (63.6% vs. 1.6%, p<0.001), and positive family history (54.5% vs. 50.1%, p=0.03). Of all 3,018 patients that were still alive at 3-year follow-up, chest pain data was available in 2,782 (92.2%) patients. At 3-year follow-up, 1,122 (40.3%) of these patients were <65 years of age, and 1,660 (59,7%) were >=65 years. Women <65 years of age reported significantly more chest pain at rest or mild exertion than men of the same age (11.7% vs. 5.9%, p=0.01), multivariate analysis showed that gender was an independent predictor (adjusted OR 1.91 95%-CI:1.1-3.2, p=0.01). In patients >=65 years, both women and men reported similar levels of chest pain at rest or mild exertion (8.8% and 8.7%, p=0.76); in this subgroup gender did not independently predict chest pain (adjusted OR 1.27 95%-CI:0.8-1.9, p=0.26). Nevertheless, in women and men similar 3-year rates of TVF, MACE, and POCE were found (11.6% vs. 11.3%, p=0.81; 13.6% vs. 12.5%, p=0.43; 18.8% vs. 18.0%, p=0.60, respectively). CONCLUSION While for both genders the incidence of adverse cardiovascular events was low and similar, women <65 years of age showed a significantly higher prevalence of chest pain at rest or mild exertion at 3-year follow-up.

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M., K., L., V. D. H., M., L., P., Z., C.J.M., D., P., D., … R., M. (2016). Impact of gender and age on 3-year clinical outcome and chest pain of patients with coronary artery disease treated with contemporary drug-eluting stents: A patient-level pooled analysis. Journal of the American College of Cardiology, 68(18 Supplement 1), B146. Retrieved from http://ovidsp.ovid.com/ovidweb.cgi?T=JS&PAGE=reference&D=emed17&NEWS=N&AN=614160985

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