Abstract 16049: A Comparison of Short- and Medium-Term Outcomes Between Men and Women Undergoing Percutaneous Coronary Intervention in a Chinese Population During the Contemporary Era of Drug-Eluting Stents

Circulation ◽  
2014 ◽  
Vol 130 (suppl_2) ◽  
Author(s):  
Peiyuan He ◽  
Yuejin Yang ◽  
Shubin Qiao ◽  
Bo Xu ◽  
Yongjian Wu ◽  
...  
Keyword(s):  
Percutaneous Coronary Intervention ◽  
Major Bleeding ◽  
Chinese Population ◽  
Coronary Intervention ◽  
Drug Eluting Stents ◽  
Access Site ◽  
Men And Women ◽  
Percutaneous Coronary ◽  
Drug Eluting

Background: Very few studies have compared the percutaneous coronary intervention (PCI) outcomes between men and women among Asian population in the era of drug-eluting stents (DES). We aimed to evaluate the sex-specific disparities in a Chinese population. Methods: From June 1, 2006 to April 30, 2011, a total of 21,964 coronary artery disease patients who have undergone PCI with stents implantation were included from one single Chinese heart center. Among them, 17209 were males, and 4755 were females. The primary endpoint was defined as major cardiovascular events (MACE) during hospitalization and at 1 year follow-up, which included cardiac death, myocardial infarction (MI), and target vessel revascularization (TVR). The secondary endpoint was defined as each component of MACE. Major bleeding after the procedure was recognized as the safety endpoint. Results: The rates of MACE during hospitalization and at 1 year follow-up were similar between men and women (in-hospital: 1.5% vs. 1.6%, P=0.730, at 1 year follow-up: 4.0% vs. 4.1%, P=0.589). The adjusted rates of the primary endpoint was still similar (in-hospital odds ratio [OR], 0.94; 95% confidence interval [CI], 0.66–1.33, at 1 year follow-up hazard ratio [HR], 1.00; 95% CI, 0.96-1.04). No significant differences were detected in each component of MACE (P all > 0.05). But major bleeding after PCI occurred more in women than in men (1.2% vs. 0.7%, P=0.002), mainly driven by the access site-related major bleeding (0.8% vs. 0.4%, P=0.002). The access site complications were also more frequent in women (2.5% vs. 1.6%, P <0.001). Conclusions: In the Chinese population with frequent use of DES, women present similar in-hospital and 1 year major outcomes compared with men. But women have higher risk of major bleeding and access site complications.

scholarly journals Dual antiplatelet therapy in patients with coronary artery disease after percutaneous coronary intervention with drug-eluting stents: A systematic review and network meta-analysis

2020 ◽  
Author(s):  
Yi Xu ◽  
Yimin Shen ◽  
Pengfei Zhao ◽  
Yuanyuan Han ◽  
Jun Jiang
Keyword(s):  
Percutaneous Coronary Intervention ◽  
Major Bleeding ◽  
Meta Analysis ◽  
Coronary Intervention ◽  
Drug Eluting Stents ◽  
Efficacy And Safety ◽  
Short Term ◽  
Percutaneous Coronary ◽  
All Cause Mortality ◽  
Drug Eluting

Abstract Background: This network meta-analysis was committed to evaluating the efficacy and safety of different dual antiplatelet therapies (DAPTs) after percutaneous coronary intervention (PCI) with drug-eluting stents (DESs).Methods: Randomized controlled trials (RCTs) comparing two of the following DAPT strategies: long-term (>12 months) DAPT (L-DAPT), 12-months DAPT (DAPT 12Mo), short-term (≤6 months) DAPT followed by aspirin monotherapy (S-DAPT+ASA), short-term DAPT followed by a P2Y12 receptor inhibitor monotherapy (S-DAPT+P2Y12) were searched. Primary outcomes were all-cause mortality, cardiac death, myocardial infarction (MI), stroke, major bleeding, any bleeding, definite or probable stent thrombosis (ST). This Bayesian network meta-analysis was performed with the random-effects model.Results: Twenty-four RCTs (n=81,376) were included. L-DAPT increased the risk of major bleeding (OR 2.37, 95%CI 1.32-5.03 compared with S-DAPT+P2Y12) and any bleeding (OR 2.95, 95%CI 1.91-4.34 compared with S-DAPT+P2Y12). When compared with L-DAPT, DAPT 12Mo (OR 1.54, 95%CI 1.13-2.02) and DAPT+ASA (OR 1.67, 95%CI 1.22-2.19) were associated with higher rates of MI, but S-DAPT+P2Y12 obtained no statistical difference. The sensitivity analysis revealed that the risks of major bleeding and any bleeding further increased for ≥18 months of DAPT. In the subgroup analysis, short-term DAPT (S-DAPT) presented similar efficacy and safety to DAPT 12Mo for patients with the acute coronary syndrome (ACS), and lower risks of major bleeding and all-cause mortality were observed in S-DAPT+P2Y12 among patients with newer-generation DES.Conclusions: S-DAPT+P2Y12 presented superiority in patients with all clinical presentations, for a lower risk of bleeding and not associated with increased ischemic harm. Besides, prospective research between aspirin monotherapy and P2Y12 monotherapy was required.

Abstract 13853: Routine Follow Up Coronary Angiography versus Clinical Follow Up Only in Patients With Dyslipidemia Following Percutaneous Coronary Intervention With Drug-eluting Stents: 3-year Clinical Follow Up Results

Circulation ◽  
2015 ◽  
Vol 132 (suppl_3) ◽  
Author(s):  
Seung Woon Rha ◽  
Byoung Geol Choi ◽  
Se Yeon Choi ◽  
Jae Kyeong Byun ◽  
Jin Oh Na ◽  
...  
Keyword(s):  
Percutaneous Coronary Intervention ◽  
Coronary Angiography ◽  
Coronary Intervention ◽  
Drug Eluting Stents ◽  
Control Group ◽  
Cardiac Events ◽  
Repeat Revascularization ◽  
Percutaneous Coronary ◽  
Drug Eluting

Background: It is unclear whether the routine follow up (FU) coronary angiography (CAG) regardless of patient’s symptoms after successful percutaneous coronary intervention (PCI) with drug-eluting stents (DESs) in patients (pts) with dyslipidemia is beneficial or not. Methods: The study population consisted of 554 consecutive dyslipidemia pts underwent PCI with unrestricted utilization of DESs from January 2004 to May 2011. Routine FU CAG was performed between 6 to 9 months following index PCI and was decided by individual physician’s discretion. Rests of the pts were clinically followed and ischemic driven events were captured. Clinical events including mortality, myocardial infarction and clinically driven PCI before 9 months were excluded in both groups. Cumulative clinical outcomes up to 3 years were compared between the Routine CAG group (n=329 pts) and the Clinical FU group (n= 225 pts). To adjust potential confounders, a propensity score matched (PSM) analysis was performed using the logistic regression model. Results: After PSM analysis, 2 propensity-matched groups (165 pairs, n = 330 pts, C-statistic=0.718) were generated and, the baseline characteristics of the two groups were balanced. At 3 years, the incidence of repeat revascularization and major adverse cardiac events (MACEs) was higher in the Routine CAG group than the control group (Table). Conclusions: Despite the expected beneficial effects, routine FU CAG following index PCI with DESs in dyslipidemia pts was associated with higher incidence of repeat PCI and MACE up to 3 years.

scholarly journals Long-Term Percutaneous Coronary Intervention Outcomes of Patients with Chronic Kidney Disease in the Era of Second-Generation Drug-Eluting Stents

2016 ◽  
Vol 7 (2) ◽  
pp. 85-95 ◽  
Author(s):  
Wojciech Wańha ◽  
Damian Kawecki ◽  
Tomasz Roleder ◽  
Aleksandra Pluta ◽  
Kamil Marcinkiewicz ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Percutaneous Coronary Intervention ◽  
Blood Transfusion ◽  
Second Generation ◽  
Coronary Intervention ◽  
Drug Eluting Stents ◽  
Percutaneous Coronary ◽  
Drug Eluting

Background: The following registry (Katowice-Zabrze retrospective registry) aimed to assess the influence of a chronic kidney disease (CKD) on long-term clinical outcomes in patients undergoing percutaneous coronary intervention (PCI) using either first-generation (DES-I) or second-generation (DES-II) drug-eluting stents. Methods: The study group consisted of 1,908 consecutive patients, of whom 331 (17.3%) had CKD. CKD was defined as an estimated glomerular filtration rate of <60 mL/min/m2. We evaluated the major adverse cardiac and cerebral events (MACCE), i.e., the composite of death, myocardial infarction (MI), stroke, and target vessel revascularization at the 12-month follow-up. Results: CKD patients had a lower left ventricular ejection fraction and more often a history of MI and PCI. Coronary angiography revealed that multivessel coronary artery disease, intracoronary thrombus, and extensive calcifications were more frequent in patients with CKD. However, the SYNTAX score did not vary between patients with or without CKD. There was a higher rate of in-hospital bleedings requiring blood transfusion in patients with CKD. At the 1-year follow-up, MACCE (17.8 vs. 12.6%, HR = 1.46 [95% CI 1.05-2.03], p = 0.009) and death (8.4 vs. 2.3%, HR = 3.9 [95% CI 2.0-7.5], p < 0.001) were more often observed in CKD patients. Multivariable Cox analysis revealed that CKD was an independent risk predictor of death after PCI at the 1-year follow-up (HR = 2.1 [95% CI 1.2-3.6], p = 0.004). In comparison to DES-I, the use of DES-II did not decrease the adverse effect of CKD on MACCE. Conclusion: CKD patients had an increased risk of in-hospital bleeding requiring blood transfusion and a higher risk of MACCE and death at the 12-month follow-up. The use of second-generation DES did not improve clinical outcomes in patients with CKD at the 12-month follow-up.

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