Gender-based outcomes in percutaneous coronary intervention with drug-eluting stents (from the National Heart, Lung, and Blood Institute Dynamic Registry).
Gender-based outcomes in percutaneous coronary intervention with drug-eluting stents (from the National Heart, Lung, and Blood Institute Dynamic Registry).
复制标题
使用药物洗脱支架进行经皮冠状动脉介入治疗的基于性别的结果（来自国家心、肺和血液研究所动态登记处）。
DOI：
10.1016/j.amjcard.2006.09.109
复制
发表时间：
2007
期刊：
影响因子：
--
通讯作者：
NationalHeart,Lung,andBloodInstituteDynamicRegistry
中科院分区：
文献类型：
--
作者：
Abbott,JDawn;Vlachos,HelenA;Selzer,Faith;Sharaf,BarryL;Holper,Elizabeth;Glaser,Ruchira;Jacobs,AliceK;Williams,DavidO;NationalHeart,Lung,andBloodInstituteDynamicRegistry
尚未对接受药物洗脱支架（DES）经皮冠状动脉介入治疗（PCI）的非手术患者进行基于性别的结局评价。我们研究了在常规临床实践中，与裸金属支架（BMS）相比，性别是否影响DES的相对安全性和有效性。使用国家心肺血液研究所动态登记研究，在接受≥1个DES（486名女性，974名男性）或BMS（631名女性，1，132名男性）的患者中，按性别对院内和1年结局进行分层。性别之间存在显著的基线差异，包括女性年龄较大和合并症患病率较高，男性既往冠状动脉疾病较多。在接受BMS或DES治疗的患者中，院内心肌梗死、冠状动脉旁路移植术和死亡没有性别相关差异。DES组1年时抗血小板药物使用和支架内血栓形成（女性1.3% vs男性1.2%，p = 0.85）相似。1年时，DES患者的重复PCI率较低（女性14.1% vs 9.5%，p = 0.02;男性12.0% vs 8.8%，p = 0.02）。BMS和DES患者的校正1年结局（包括死亡和心肌梗死）与性别无关。除年龄外，使用DES是唯一降低女性（相对风险0.61，95%置信区间0.41 - 0.89，p = 0.01）和男性（相对风险0.68，95%置信区间0.51 - 0.91，p = 0.001）再次PCI风险的因素。总之，DES的广泛使用是安全的，与BMS相比，在女性和男性中同样减少了临床驱动的血运重建。
Gender-based outcomes have not been evaluated in unselected patients undergoing percutaneous coronary intervention (PCI) with drug-eluting stents (DESs). We investigated whether gender influences the relative safety and efficacy of DESs compared with bare metal stents (BMSs) in routine clinical practice. Using the National Heart, Lung, and Blood Institute Dynamic Registry, in-hospital and 1-year outcomes were stratified by gender in patients who received ≥1 DES (486 women, 974 men) or BMS (631 women, 1,132 men). There were significant baseline differences by gender, including older age and a higher prevalence of co-morbidities in women and more previous coronary artery disease in men. There were no gender-related differences in in-hospital myocardial infarction, coronary artery bypass grafting, and death in those treated with BMSs or DESs. Antiplatelet use and stent thrombosis (1.3% of women vs 1.2% of men, p = 0.85) were similar at 1 year with DESs. At 1 year, patients with DESs had a lower rate of repeat PCI (14.1% in women vs 9.5%, p = 0.02; 12.0% in men vs 8.8%, p = 0.02). Adjusted 1-year outcomes in patients with BMSs and DESs, including death and myocardial infarction, were independent of gender. Use of DESs was the only factor, other than age, that conferred a lower risk for the need for repeat PCI in women (relative risk 0.61, 95% confidence interval 0.41 to 0.89, p = 0.01) and men (relative risk 0.68, 95% confidence interval 0.51 to 0.91, p = 0.001). In conclusion, the widespread use of DESs is safe and has decreased clinically driven revascularization compared with BMSs equally in women and men.